File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Pain Relief After Total Knee Arthroplasty with Intravenous and Periarticular Corticosteroid

TitlePain Relief After Total Knee Arthroplasty with Intravenous and Periarticular Corticosteroid
Other TitlesA Randomized Controlled Trial
Authors
Issue Date23-May-2023
PublisherLippincott, Williams & Wilkins
Citation
Journal of Bone and Joint Surgery, 2023, v. 105, n. 12, p. 924-932 How to Cite?
Abstract

Background: 

Total knee arthroplasty (TKA) is a cost-effective procedure, but it is also associated with substantial postoperative pain. The present study aimed to compare pain relief and functional recovery after TKA among groups that received intravenous corticosteroids, periarticular corticosteroids, or a combination of both.

Methods: 

This randomized, double-blinded clinical trial in a local institution in Hong Kong recruited 178 patients who underwent primary unilateral TKA. Six of these patients were excluded because of changes in surgical technique; 4, because of their hepatitis B status; 2, because of a history of peptic ulcer; and 2, because they declined to participate in the study. Patients were randomized 1:1:1:1 to receive placebo (P), intravenous corticosteroids (IVS), periarticular corticosteroids (PAS), or a combination of intravenous and periarticular corticosteroids (IVSPAS).

Results: 

The pain scores at rest were significantly lower in the IVSPAS group than in the P group over the first 48 hours (p = 0.034) and 72 hours (p = 0.043) postoperatively. The pain scores during movement were also significantly lower in the IVS and IVSPAS groups than in the P group over the first 24, 48, and 72 hours (p ≤ 0.023 for all). The flexion range of the operatively treated knee was significantly better in the IVSPAS group than in the P group on postoperative day 3 (p = 0.027). Quadriceps power was also greater in the IVSPAS group than in the P group on postoperative days 2 (p = 0.005) and 3 (p = 0.007). Patients in the IVSPAS group were able to walk significantly further than patients in the P group in the first 3 postoperative days (p ≤ 0.003). Patients in the IVSPAS group also had a higher score on the Elderly Mobility Scale than those in the P group (p = 0.036).

Conclusions: 

IVS and IVSPAS yielded similar pain relief, but IVSPAS yielded a larger number of rehabilitation parameters that were significantly better than those in the P group. This study provides new insights into pain management and postoperative rehabilitation following TKA.


Persistent Identifierhttp://hdl.handle.net/10722/329197
ISSN
2023 Impact Factor: 4.4
2023 SCImago Journal Rankings: 1.705
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, PK-
dc.contributor.authorChan, TCW-
dc.contributor.authorMak, CYH-
dc.contributor.authorChan, THM-
dc.contributor.authorChan, SHW-
dc.contributor.authorWong, SSC-
dc.contributor.authorFu, H-
dc.contributor.authorCheung, A-
dc.contributor.authorChan, VWK-
dc.contributor.authorCheung, MH-
dc.contributor.authorCheung, CW-
dc.contributor.authorChiu, KY-
dc.date.accessioned2023-08-05T07:56:01Z-
dc.date.available2023-08-05T07:56:01Z-
dc.date.issued2023-05-23-
dc.identifier.citationJournal of Bone and Joint Surgery, 2023, v. 105, n. 12, p. 924-932-
dc.identifier.issn0021-9355-
dc.identifier.urihttp://hdl.handle.net/10722/329197-
dc.description.abstract<h3>Background: </h3><p>Total knee arthroplasty (TKA) is a cost-effective procedure, but it is also associated with substantial postoperative pain. The present study aimed to compare pain relief and functional recovery after TKA among groups that received intravenous corticosteroids, periarticular corticosteroids, or a combination of both.</p><h3>Methods: </h3><p>This randomized, double-blinded clinical trial in a local institution in Hong Kong recruited 178 patients who underwent primary unilateral TKA. Six of these patients were excluded because of changes in surgical technique; 4, because of their hepatitis B status; 2, because of a history of peptic ulcer; and 2, because they declined to participate in the study. Patients were randomized 1:1:1:1 to receive placebo (P), intravenous corticosteroids (IVS), periarticular corticosteroids (PAS), or a combination of intravenous and periarticular corticosteroids (IVSPAS).</p><h3>Results: </h3><p>The pain scores at rest were significantly lower in the IVSPAS group than in the P group over the first 48 hours (p = 0.034) and 72 hours (p = 0.043) postoperatively. The pain scores during movement were also significantly lower in the IVS and IVSPAS groups than in the P group over the first 24, 48, and 72 hours (p ≤ 0.023 for all). The flexion range of the operatively treated knee was significantly better in the IVSPAS group than in the P group on postoperative day 3 (p = 0.027). Quadriceps power was also greater in the IVSPAS group than in the P group on postoperative days 2 (p = 0.005) and 3 (p = 0.007). Patients in the IVSPAS group were able to walk significantly further than patients in the P group in the first 3 postoperative days (p ≤ 0.003). Patients in the IVSPAS group also had a higher score on the Elderly Mobility Scale than those in the P group (p = 0.036).</p><h3>Conclusions: </h3><p>IVS and IVSPAS yielded similar pain relief, but IVSPAS yielded a larger number of rehabilitation parameters that were significantly better than those in the P group. This study provides new insights into pain management and postoperative rehabilitation following TKA.</p>-
dc.languageeng-
dc.publisherLippincott, Williams & Wilkins-
dc.relation.ispartofJournal of Bone and Joint Surgery-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titlePain Relief After Total Knee Arthroplasty with Intravenous and Periarticular Corticosteroid-
dc.title.alternativeA Randomized Controlled Trial-
dc.typeArticle-
dc.identifier.doi10.2106/JBJS.22.01218-
dc.identifier.scopuseid_2-s2.0-85163862702-
dc.identifier.volume105-
dc.identifier.issue12-
dc.identifier.spage924-
dc.identifier.epage932-
dc.identifier.eissn1535-1386-
dc.identifier.isiWOS:001030341600008-
dc.identifier.issnl0021-9355-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats