Details

Autor(en) / Beteiligte

• Cheng, Bernadette Lok Yiu
• So, Eric Hang Kwong
• Hui, Grace Kit Man
• Yung, Boogie Pui Ki
• Tsui, Ada Sau Kwan
• Wang, Oscar Kam Fung
• Poon, Margaret Wai Yee
• Chan, Andy C. M.
• Wong, Steven H. S.
• Li, Wilson
• Yip, Paul Sin Chuen

Titel

Pre-operative intravenous steroid improves pain and joint mobility after total knee arthroplasty in Chinese population: a double-blind randomized controlled trial

Ist Teil von

• European journal of orthopaedic surgery & traumatology, 2019-10, Vol.29 (7), p.1473-1479

Ort / Verlag

Paris: Springer Paris

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Introduction This study aims to investigate the effect of pre-operative intravenous methylprednisolone on post-operative pain control and joint mobility in Chinese patients undergoing single primary total knee arthroplasty. Methods This is a prospective, randomized, double-blinded, placebo-controlled single-centre trial. Sixty subjects were randomized into intervention and control group. The peri-operative anaesthetic and analgesic regimes were standardized. The intervention group received 125 mg methylprednisolone intravenously on the induction of anaesthesia. Subjects were assessed at 24, 30 and 48 h after surgery and upon discharge for pain scores and range of movement from the operated knee. Change in C-reactive protein level was calculated. Patient’s satisfaction was recorded. Adverse reactions were documented. Subjects were followed up at 6 weeks, 4 months and 1 year. Results Rest pain and pain on movement were significantly reduced in the methylprednisolone group at 24 and 30 h after surgery (ANOVA p  = 0.030, p  = 0.003, p  = 0.032, p  = 0.010). The methylprednisolone group demonstrated a greater range of movement from the operated knee up to 30 h after surgery (ANOVA p  = 0.031). Post-operative C-reactive protein level was significantly less in the methylprednisolone group ( p  < 0.001). Methylprednisolone group had a higher patient’s satisfaction than the control group ( p  < 0.01). No adverse effects were noted at the 1-year follow-up. Conclusion Pre-operative intravenous methylprednisolone improves post-operative pain and joint mobility after total knee arthroplasty up to 30 h after operation. It results in a higher patients’ satisfaction. It can act as an effective adjunct in the multimodal analgesic regime. Trial registration ClinicalTrials.gov ID: NCT03082092.