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Article: Combination Effect of High-Dose Preoperative and Periarticular Steroid Injection in Total Knee Arthroplasty. A Randomized Controlled Study

TitleCombination Effect of High-Dose Preoperative and Periarticular Steroid Injection in Total Knee Arthroplasty. A Randomized Controlled Study
Authors
KeywordsTotal knee arthroplasty
Fast-track arthroplasty
Enhanced recovery after surgery
Pain control
Corticosteroids
Local infiltration analgesics
Issue Date2021
PublisherChurchill Livingstone. The Journal's web site is located at http://www.elsevier.com/locate/arthroplastyjournal
Citation
Journal of Arthroplasty, 2021, v. 36 n. 1, p. 130-134.e2 How to Cite?
AbstractBackground: Postoperative pain remains a major barrier to a patient’s recovery after total knee arthroplasty (TKA). Periarticular corticosteroids in local infiltration analgesics (LIA) and high-dose intravenous corticosteroids have individually shown to improve pain control after TKA. However, potential interactions between them have not been investigated. This study aims to evaluate any combination effect of both routes of corticosteroids in TKA. Methods: This is a double-blinded, paired, randomized controlled trial involving 1-stage bilateral TKAs. All received 16 mg of dexamethasone intravenously. One knee was randomized to receive LIA with 40 mg of triamcinolone, while the other knee receives LIA without corticosteroids. For each patient, one knee was affected by intravenous steroids only, while the other was under the combined effect of intravenous and periarticular steroids (IVPAS). Knee pain, Southampton wound scores, and functional knee scores (Knee Society Knee Score and Oxford Knee Scores) were compared between knees of the same patient. Results: Forty-six patients (92 TKAs) were included. IVPAS knees showed significantly lower visual analog scale scores from day 1 to 6 weeks (P < .05) and a larger range of movement from day 2 to 4 (P < .05). IVPAS knees achieved active straight leg raise earlier than intravenous steroids (1.6 vs 2.3 days, P < .05). No differences in Southampton wound scores and functional knee scores for up to 1 year. Conclusion: Combining intravenous and periarticular corticosteroids improved pain control and recovery after TKA with no increase in wound complications up to 1 year.
Persistent Identifierhttp://hdl.handle.net/10722/306333
ISSN
2023 Impact Factor: 3.4
2023 SCImago Journal Rankings: 1.849
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, VWK-
dc.contributor.authorChan, PK-
dc.contributor.authorFu, H-
dc.contributor.authorChan, CW-
dc.contributor.authorYan, CH-
dc.contributor.authorChiu, KY-
dc.date.accessioned2021-10-20T10:22:08Z-
dc.date.available2021-10-20T10:22:08Z-
dc.date.issued2021-
dc.identifier.citationJournal of Arthroplasty, 2021, v. 36 n. 1, p. 130-134.e2-
dc.identifier.issn0883-5403-
dc.identifier.urihttp://hdl.handle.net/10722/306333-
dc.description.abstractBackground: Postoperative pain remains a major barrier to a patient’s recovery after total knee arthroplasty (TKA). Periarticular corticosteroids in local infiltration analgesics (LIA) and high-dose intravenous corticosteroids have individually shown to improve pain control after TKA. However, potential interactions between them have not been investigated. This study aims to evaluate any combination effect of both routes of corticosteroids in TKA. Methods: This is a double-blinded, paired, randomized controlled trial involving 1-stage bilateral TKAs. All received 16 mg of dexamethasone intravenously. One knee was randomized to receive LIA with 40 mg of triamcinolone, while the other knee receives LIA without corticosteroids. For each patient, one knee was affected by intravenous steroids only, while the other was under the combined effect of intravenous and periarticular steroids (IVPAS). Knee pain, Southampton wound scores, and functional knee scores (Knee Society Knee Score and Oxford Knee Scores) were compared between knees of the same patient. Results: Forty-six patients (92 TKAs) were included. IVPAS knees showed significantly lower visual analog scale scores from day 1 to 6 weeks (P < .05) and a larger range of movement from day 2 to 4 (P < .05). IVPAS knees achieved active straight leg raise earlier than intravenous steroids (1.6 vs 2.3 days, P < .05). No differences in Southampton wound scores and functional knee scores for up to 1 year. Conclusion: Combining intravenous and periarticular corticosteroids improved pain control and recovery after TKA with no increase in wound complications up to 1 year.-
dc.languageeng-
dc.publisherChurchill Livingstone. The Journal's web site is located at http://www.elsevier.com/locate/arthroplastyjournal-
dc.relation.ispartofJournal of Arthroplasty-
dc.subjectTotal knee arthroplasty-
dc.subjectFast-track arthroplasty-
dc.subjectEnhanced recovery after surgery-
dc.subjectPain control-
dc.subjectCorticosteroids-
dc.subjectLocal infiltration analgesics-
dc.titleCombination Effect of High-Dose Preoperative and Periarticular Steroid Injection in Total Knee Arthroplasty. A Randomized Controlled Study-
dc.typeArticle-
dc.identifier.emailChan, VWK: cwkvince@hku.hk-
dc.identifier.emailChan, PK: cpk464@hku.hk-
dc.identifier.emailFu, H: drhfu@hku.hk-
dc.identifier.emailChan, CW: timkat@hkucc.hku.hk-
dc.identifier.emailChiu, KY: pkychiu@hkucc.hku.hk-
dc.identifier.authorityFu, H=rp02904-
dc.identifier.authorityYan, CH=rp00303-
dc.identifier.authorityChiu, KY=rp00379-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.arth.2020.07.033-
dc.identifier.pmid32773268-
dc.identifier.scopuseid_2-s2.0-85089135788-
dc.identifier.hkuros326696-
dc.identifier.volume36-
dc.identifier.issue1-
dc.identifier.spage130-
dc.identifier.epage134.e2-
dc.identifier.isiWOS:000597265500023-
dc.publisher.placeUnited States-

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