In general, injections with cortisone are safe. The key to a successful injection with minimal side effects is placing the medication in the correct location. After thousands of arthroscopic surgeries, Dr. Romeo is able to do this routinely with no additional supportive devices such as ultrasound guidance, which add to the overall cost of the treatment. After the injection, he confirms with the patient that the area that was causing symptoms has been resolved with the local anesthetic that is placed with the cortisone. However, if there is any concern over placing the medications in the correct location, ultrasound guidance may be helpful.
Cortisone shots have been associated with a local hyperreaction which causes a short term increase in pain, potential degradation of the local tissues due to treatment of inflammation which is a normal part of the healing process, increased risk of elevated glucose levels in diabetics, and increased risk of infection, especially if surgery is performed relatively soon after the injection. For most patients, the frustrating aspect of these injections is that they often provide incomplete symptom relief and the duration of effectiveness is weeks to months. Because of this, numerous other treatment modalities are combined with cortisone injections or used instead of an injection.