Last reviewed: September 29, 2026

Usually not in the last three months before surgery. The concern is infection of the new hip, one of the most serious problems after a hip replacement.

Large studies of hip replacements found that a cortisone shot into the same hip within about three months of surgery was linked to more infection afterward. Shots given earlier were not clearly linked. One study found that each extra shot in those last months added to the risk, and another linked more than two shots in the two years before surgery to more infection. When hips and knees were compared, the link was clearer for hips.

The evidence has limits. It comes from records, not trials, so it shows a link rather than proof of cause. Some smaller studies found no increase.

There is a second, separate concern. In a small share of people, the hip joint breaks down unusually fast in the months after a cortisone shot, more often when the arthritis is already advanced. Studies disagree on how often, and whether the shot is the cause is not settled.

According to the American Academy of Orthopaedic Surgeons, a cortisone shot can ease hip pain for a short time. But once a hip is bad enough to replace, a guideline from rheumatology and joint replacement surgeon groups advises against putting off surgery to try more shots. Its evidence is low quality.

In general:

  • Tell your surgeon about any cortisone shot in the months before surgery, in any joint.
  • If surgery is already scheduled, ask before getting another shot in that hip.
  • Hip pain that gets much worse in the months after a shot is worth reporting.
  • People with diabetes may see higher sugar readings after a shot.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

  • Werner BC, et al. The Timing of Total Hip Arthroplasty After Intraarticular Hip Injection Affects Postoperative Infection Risk. J Arthroplasty. 2016. https://doi.org/10.1016/j.arth.2015.08.032
  • Schairer WW, et al. Preoperative Hip Injections Increase the Rate of Periprosthetic Infection After Total Hip Arthroplasty. J Arthroplasty. 2016. https://doi.org/10.1016/j.arth.2016.04.008
  • Prkić A, et al. Role of Preoperative Intra-Articular Corticosteroid Injections on Periprosthetic Joint Infection in Total Hip Arthroplasty and Its Association With Preoperative Timing: A Single-Center Series of 5,909 Hips. J Arthroplasty. 2024. https://doi.org/10.1016/j.arth.2024.02.063
  • Forlenza EM, et al. Preoperative Corticosteroid Injections Demonstrate a Temporal and Dose-Dependent Relationship with the Rate of Postoperative Infection Following Total Hip Arthroplasty. J Arthroplasty. 2021. https://doi.org/10.1016/j.arth.2021.01.076
  • Raymond HE, et al. Risk of Infection After Total Knee or Hip Arthroplasty After Receipt of Multiple Corticosteroid or Hyaluronic Acid Injections. J Am Acad Orthop Surg. 2023. https://doi.org/10.5435/JAAOS-D-22-01177
  • Lai Q, et al. Prior Intra-articular Corticosteroid Injection Within 3 Months May Increase the Risk of Deep Infection in Subsequent Joint Arthroplasty: A Meta-analysis. Clin Orthop Relat Res. 2022. https://doi.org/10.1097/CORR.0000000000002055
  • Albanese J, et al. Infection Risk Increases After Total Hip Arthroplasty Within 3 Months Following Intra-Articular Corticosteroid Injection. A Meta-Analysis on Knee and Hip Arthroplasty. J Arthroplasty. 2023. https://doi.org/10.1016/j.arth.2022.12.038
  • Pereira LC, et al. Intra-Articular Steroid Injection for Osteoarthritis of the Hip Prior to Total Hip Arthroplasty: Is It Safe? A Systematic Review. Bone Joint J. 2016. https://doi.org/10.1302/0301-620X.98B8.37420
  • Streck LE, et al. How Safe Are Intra-Articular Corticosteroid Injections to the Hip? BMC Musculoskelet Disord. 2023. https://doi.org/10.1186/s12891-023-06766-3
  • Kelliher A, et al. Efficacy of Intra-Articular Corticosteroid Injection for Hip Osteoarthritis: A Systematic Review With Meta-Analysis. J Arthroplasty. 2026. https://doi.org/10.1016/j.arth.2026.07.024
  • Kompel AJ, et al. Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought? Radiology. 2019. https://doi.org/10.1148/radiol.2019190341
  • Hannon CP, et al. American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary: Management of Osteoarthritis of the Hip. J Am Acad Orthop Surg. 2024. https://doi.org/10.5435/JAAOS-D-24-00420
  • Hannon CP, et al. 2023 American College of Rheumatology and American Association of Hip and Knee Surgeons Clinical Practice Guideline for the Optimal Timing of Elective Hip or Knee Arthroplasty. Arthritis Rheumatol. 2023. https://doi.org/10.1002/art.42630
  • Benzon HT, et al. Use and Safety of Corticosteroid Injections in Joints and Musculoskeletal Soft Tissue: Guidelines From the American Society of Regional Anesthesia and Pain Medicine and Others. Reg Anesth Pain Med. 2026. https://doi.org/10.1136/rapm-2024-105656

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

Published by Clinical Evidence Media LLC. Full disclaimer and how these answers are researched: Disclaimer and how these answers are made