Last reviewed: September 29, 2026

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

Several large studies, pooled together, found that a cortisone shot into the same knee within about three months of the replacement was linked to a higher rate of infection afterward. Shots given earlier were not clearly linked to more infection. Most hip and knee surgeons who were surveyed wait at least three months between a shot and surgery.

The evidence has limits. It comes from records, not trials, so it shows a link rather than proof of cause. Some studies, including a large national study from England, found no increase in problems after surgery.

Shots elsewhere, such as in the other knee or a shoulder, have not been studied the same way. In people with diabetes, a cortisone shot into a joint can raise blood sugar for a few days.

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 knee.
  • Before a cortisone shot in another joint, such as a shoulder or the other knee, talk it over with your surgeon first.
  • People with diabetes may see higher sugar readings for a few days after a shot.

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

Sources:

  • Baums MH, et al. Risk Analysis of Periprosthetic Knee Joint Infection (PJI) in Total Knee Arthroplasty After Preoperative Corticosteroid Injection: A Systematic Review. Arch Orthop Trauma Surg. 2023. https://doi.org/10.1007/s00402-022-04532-z
  • Richardson SS, et al. Comparison of Infection Risk With Corticosteroid or Hyaluronic Acid Injection Prior to Total Knee Arthroplasty. J Bone Joint Surg Am. 2019. https://doi.org/10.2106/JBJS.18.00454
  • Rhode DT, et al. Do Intra-Articular Corticosteroid Injections Prior to Total Knee Arthroplasty Increase Postoperative Complication Rates: A Retrospective Review. J Knee Surg. 2023. https://doi.org/10.1055/s-0041-1731327
  • Hawley S, et al. Effect of Intra-Articular Corticosteroid Injections for Knee Osteoarthritis on the Rates of Subsequent Knee Replacement and Post-Operative Outcomes: A National Cohort Study of England. BMC Med. 2025. https://doi.org/10.1186/s12916-025-04000-6
  • Blankstein M, et al. Common Practices in Intra-Articular Corticosteroid Injection for the Treatment of Knee Osteoarthritis: A Survey of the American Association of Hip and Knee Surgeons Membership. J Arthroplasty. 2021. https://doi.org/10.1016/j.arth.2020.09.022
  • Kallock E, et al. Clinical Inquiries. Do Intra-Articular Steroid Injections Affect Glycemic Control in Patients With Diabetes? J Fam Pract. 2010. https://pubmed.ncbi.nlm.nih.gov/21135928/
  • Spitzer AI, et al. Extended-Release Versus Immediate-Release Triamcinolone Acetonide in Patients Who Have Knee Osteoarthritis and Type 2 Diabetes Mellitus. J Arthroplasty. 2024. https://doi.org/10.1016/j.arth.2024.05.055

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.

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