Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2011

01.01.2011 | Knee

Effects of periarticular steroid injection on knee function and the inflammatory response following unicondylar knee arthroplasty

verfasst von: Yung Chuan Sean Ng, Ngai Nung Lo, Kuang Ying Yang, Shi Lu Chia, Hwei Chi Chong, Seng Jin Yeo

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 1/2011

Einloggen, um Zugang zu erhalten

Abstract

There is little information on the values of CRP and ESR as markers for inflammation in Unicondylar Knee Arthroplasty. The effect of periarticular steroid injection in post-operative pain relief and clinical recovery has not been well studied. Eighty-three consecutive patients undergoing primary UKAs were randomized to receive either an intra-operative periarticular injection with a local anaesthetic and adrenaline or with the addition of triamcinolone acetonide. CRP and ESR values, pain VAS and other scores, as well as clinical functional parameters, were obtained and analysed. Patients were assessed daily till discharge and up to 6 months post-operatively. Plasma CRP and ESR fluctuate after a UKA, with normalizing values indicating uneventful recovery. Periarticular steroid injections reduce post-operative pain and inflammation, and are clinically relevant as they improve short-term functional recovery and clinical parameters, resulting in better outcomes for patients without having major complications.
Literatur
1.
Zurück zum Zitat Aalto K, Osterman K, Peltola H, Räsänen J (1984) Changes in erythrocyte sedimentation rate and C-reactive protein after total hip arthroplasty. Clin Orthop Relat Res 184:118–120PubMed Aalto K, Osterman K, Peltola H, Räsänen J (1984) Changes in erythrocyte sedimentation rate and C-reactive protein after total hip arthroplasty. Clin Orthop Relat Res 184:118–120PubMed
2.
Zurück zum Zitat Ackland GL, Scollay JM, Parks RW, de Beaux I, Mythen MG (2007) Pre-operative high sensitivity C-reactive protein and postoperative outcome in patients undergoing elective orthopaedic surgery. Anaesthesia 62:888–894CrossRefPubMed Ackland GL, Scollay JM, Parks RW, de Beaux I, Mythen MG (2007) Pre-operative high sensitivity C-reactive protein and postoperative outcome in patients undergoing elective orthopaedic surgery. Anaesthesia 62:888–894CrossRefPubMed
3.
Zurück zum Zitat Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ (2006) Unicompartmental or total knee arthroplasty? Results from a matched study. Clin Orthop Relat Res 451:101–106CrossRefPubMed Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ (2006) Unicompartmental or total knee arthroplasty? Results from a matched study. Clin Orthop Relat Res 451:101–106CrossRefPubMed
4.
Zurück zum Zitat Bilgen O, Atici T, Durak K, Karaeminogullari O, Bilgen MS (2001) C-reactive protein values and erythrocyte sedimentation rates after total hip and total knee arthroplasty. J Int Med Res 29:7–12PubMed Bilgen O, Atici T, Durak K, Karaeminogullari O, Bilgen MS (2001) C-reactive protein values and erythrocyte sedimentation rates after total hip and total knee arthroplasty. J Int Med Res 29:7–12PubMed
5.
Zurück zum Zitat Bonica JJ (1990) Postoperative pain. The management of pain, 2nd edn. Lea and Febiger, Philadelphia, pp 461–480 Bonica JJ (1990) Postoperative pain. The management of pain, 2nd edn. Lea and Febiger, Philadelphia, pp 461–480
6.
Zurück zum Zitat Busch CA, Shore BJ, Bhandari R, Ganapathy S, MacDonald SJ, Bourne RB et al (2006) Efficacy of periarticular multimodal drug injection in total knee arthroplasty. J Bone Joint Surg Am 88:959–963CrossRefPubMed Busch CA, Shore BJ, Bhandari R, Ganapathy S, MacDonald SJ, Bourne RB et al (2006) Efficacy of periarticular multimodal drug injection in total knee arthroplasty. J Bone Joint Surg Am 88:959–963CrossRefPubMed
7.
Zurück zum Zitat Caracciolo B, Giaquinto S (2005) Determinants of the subjective functional outcome of total joint arthroplasty. Arch Gerontol Geriatr 41:169–176CrossRefPubMed Caracciolo B, Giaquinto S (2005) Determinants of the subjective functional outcome of total joint arthroplasty. Arch Gerontol Geriatr 41:169–176CrossRefPubMed
8.
Zurück zum Zitat Creamer P (1997) Intra-articular corticosteroid injections in osteoarthritis: do they work and if so, how? Ann Rheum Dis 56:634–636CrossRefPubMed Creamer P (1997) Intra-articular corticosteroid injections in osteoarthritis: do they work and if so, how? Ann Rheum Dis 56:634–636CrossRefPubMed
9.
Zurück zum Zitat DeWeese FT, Akbari Z, Carline E (2001) Pain control after knee arthroplasty: intraarticular versus epidural anesthesia. Clin Orthop Relat Res 392:226–231CrossRefPubMed DeWeese FT, Akbari Z, Carline E (2001) Pain control after knee arthroplasty: intraarticular versus epidural anesthesia. Clin Orthop Relat Res 392:226–231CrossRefPubMed
10.
Zurück zum Zitat Dutton AQ, Yeo SJ, Yang KY, Lo NN, Chia KU, Chong HC (2008) Computer-assisted minimally invasive total knee arthroplasty compared with standard total knee arthroplasty. A prospective, randomized study. J Bone Joint Surg Am 90:2–9CrossRefPubMed Dutton AQ, Yeo SJ, Yang KY, Lo NN, Chia KU, Chong HC (2008) Computer-assisted minimally invasive total knee arthroplasty compared with standard total knee arthroplasty. A prospective, randomized study. J Bone Joint Surg Am 90:2–9CrossRefPubMed
11.
Zurück zum Zitat Dupont C, Rodenbach J, Flachaire E (2008) The value of C-reactive protein for postoperative monitoring of lower limb arthroplasty. Ann Readapt Med Phys 51:348–357PubMed Dupont C, Rodenbach J, Flachaire E (2008) The value of C-reactive protein for postoperative monitoring of lower limb arthroplasty. Ann Readapt Med Phys 51:348–357PubMed
12.
Zurück zum Zitat Fisher DA, Watts M, Davis KE (2003) Implant position in knee surgery: a comparison of minimally invasive, open unicompartmental and total knee arthroplasty. J Arthroplasty 18:2–8CrossRefPubMed Fisher DA, Watts M, Davis KE (2003) Implant position in knee surgery: a comparison of minimally invasive, open unicompartmental and total knee arthroplasty. J Arthroplasty 18:2–8CrossRefPubMed
13.
Zurück zum Zitat Fuchs S, Rolauffs B, Plaumann T, Tibesku CO, Rosenbaum D (2005) Clinical and functional results after the rehabilitation period in minimally-invasive unicondylar knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc 13:179–186CrossRefPubMed Fuchs S, Rolauffs B, Plaumann T, Tibesku CO, Rosenbaum D (2005) Clinical and functional results after the rehabilitation period in minimally-invasive unicondylar knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc 13:179–186CrossRefPubMed
14.
Zurück zum Zitat Kardash KJ, Sarrazin F, Tessler MJ, Velly AM (2008) Single-dose dexamethasone reduces dynamic pain after total hip arthroplasty. Anesth Analg 106(4):1253–1257CrossRefPubMed Kardash KJ, Sarrazin F, Tessler MJ, Velly AM (2008) Single-dose dexamethasone reduces dynamic pain after total hip arthroplasty. Anesth Analg 106(4):1253–1257CrossRefPubMed
15.
Zurück zum Zitat Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V (2008) Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50, 493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop 79:499–507CrossRefPubMed Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V (2008) Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50, 493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop 79:499–507CrossRefPubMed
16.
Zurück zum Zitat Laiho K, Mäenpää H, Kautiainen H, Kauppi M, Kaarela K, Lehto M, Belt E (2001) Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis. Ann Rheum Dis 60:275–277CrossRefPubMed Laiho K, Mäenpää H, Kautiainen H, Kauppi M, Kaarela K, Lehto M, Belt E (2001) Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis. Ann Rheum Dis 60:275–277CrossRefPubMed
17.
Zurück zum Zitat Lombardi AV Jr, Berend KR, Mallory TH, Dodds KL, Adams JB (2004) Soft tissue and intra-articular injection of bupivacaine, epinephrine and morphine has a beneficial effect after total knee arthroplasty. Clin Orthop Relat Res 428:125–130CrossRefPubMed Lombardi AV Jr, Berend KR, Mallory TH, Dodds KL, Adams JB (2004) Soft tissue and intra-articular injection of bupivacaine, epinephrine and morphine has a beneficial effect after total knee arthroplasty. Clin Orthop Relat Res 428:125–130CrossRefPubMed
18.
Zurück zum Zitat Manzotti A, Confalonieri N, Pullen C (2007) Unicompartmental versus computer-assisted total knee replacement for medial compartment knee arthritis: a matched paired study. Int Orthop 31:315–319CrossRefPubMed Manzotti A, Confalonieri N, Pullen C (2007) Unicompartmental versus computer-assisted total knee replacement for medial compartment knee arthritis: a matched paired study. Int Orthop 31:315–319CrossRefPubMed
19.
Zurück zum Zitat Mäenpää H, Laiho K, Kauppi M, Kaarela K, Kautiainen H, Lehto MU, Belt EA (2002) A comparison of postoperative C-reactive protein changes in primary and revision hip arthroplasty in patients with rheumatoid arthritis. J Arthroplasty 17:108–110PubMed Mäenpää H, Laiho K, Kauppi M, Kaarela K, Kautiainen H, Lehto MU, Belt EA (2002) A comparison of postoperative C-reactive protein changes in primary and revision hip arthroplasty in patients with rheumatoid arthritis. J Arthroplasty 17:108–110PubMed
20.
Zurück zum Zitat Mont MA, Stuchin SA, Paley D, Sharkey PF, Parvisi J, Tria AJ Jr, Bonutti PM, Etienne G (2004) Different surgical options for monocompartmental osteoarthritis of the knee: high tibial osteotomy versus unicompartmental knee arthroplasty versus total knee arthroplasty: indications, techniques, results, and controversies. Instr Course Lect 53:265–283PubMed Mont MA, Stuchin SA, Paley D, Sharkey PF, Parvisi J, Tria AJ Jr, Bonutti PM, Etienne G (2004) Different surgical options for monocompartmental osteoarthritis of the knee: high tibial osteotomy versus unicompartmental knee arthroplasty versus total knee arthroplasty: indications, techniques, results, and controversies. Instr Course Lect 53:265–283PubMed
21.
Zurück zum Zitat Pang HN, Lo NN, Yang KY, Chong HC, Yeo SJ (2008) Periarticular steroid injection improves the outcome after unicondylar knee replacement: a prospective, randomized controlled trial with a two-year follow-up. J Bone Joint Surg Br 90:738–744CrossRefPubMed Pang HN, Lo NN, Yang KY, Chong HC, Yeo SJ (2008) Periarticular steroid injection improves the outcome after unicondylar knee replacement: a prospective, randomized controlled trial with a two-year follow-up. J Bone Joint Surg Br 90:738–744CrossRefPubMed
22.
Zurück zum Zitat Altman RD, Hochberg MC, Moskowitz RW, Schnitzer TJ (2000) Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis Rheum 43:1905–1915CrossRef Altman RD, Hochberg MC, Moskowitz RW, Schnitzer TJ (2000) Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis Rheum 43:1905–1915CrossRef
23.
Zurück zum Zitat Reddy PD, Zelicof SB, Ruotolo C, Holder J (1995) Interdigital neuroma. Local cutaneous changes after corticosteroid injection. Clin Orthop Relat Res 317:185–187PubMed Reddy PD, Zelicof SB, Ruotolo C, Holder J (1995) Interdigital neuroma. Local cutaneous changes after corticosteroid injection. Clin Orthop Relat Res 317:185–187PubMed
24.
Zurück zum Zitat Repicci JA (2003) Mini-invasive knee unicompartmental arthroplasty: bone-sparing technique. Surg Technol Int 11:282–286PubMed Repicci JA (2003) Mini-invasive knee unicompartmental arthroplasty: bone-sparing technique. Surg Technol Int 11:282–286PubMed
25.
Zurück zum Zitat Romanowski MR, Repicci JA (2002) Minimally invasive unicondylar arthroplasty: eight-year follow-up. J Knee Surg 15:17–22PubMed Romanowski MR, Repicci JA (2002) Minimally invasive unicondylar arthroplasty: eight-year follow-up. J Knee Surg 15:17–22PubMed
26.
Zurück zum Zitat Smith C, Erasmus PJ, Myburgh KH (2006) Endocrine and immune effects of dexamethasone in unilateral total knee replacement. J Int Med Res 34:603–611PubMed Smith C, Erasmus PJ, Myburgh KH (2006) Endocrine and immune effects of dexamethasone in unilateral total knee replacement. J Int Med Res 34:603–611PubMed
27.
Zurück zum Zitat Thebault J, Blatrix C, Blanchard J, Panak E (1982) A possible method to control prolongations of bleeding time under antiplatelet therapy with ticlopidine. Thromb Haemost 48:6–8PubMed Thebault J, Blatrix C, Blanchard J, Panak E (1982) A possible method to control prolongations of bleeding time under antiplatelet therapy with ticlopidine. Thromb Haemost 48:6–8PubMed
28.
Zurück zum Zitat Tria AJ Jr (2007) Minimally invasive total knee arthroplasty; past, present and future. Am J Orthop 36:6–7PubMed Tria AJ Jr (2007) Minimally invasive total knee arthroplasty; past, present and future. Am J Orthop 36:6–7PubMed
29.
Zurück zum Zitat Tria AJ Jr (2003) Advancements in minimally invasive total knee arthroplasty. Orthopedics 26:s859–s863PubMed Tria AJ Jr (2003) Advancements in minimally invasive total knee arthroplasty. Orthopedics 26:s859–s863PubMed
30.
Zurück zum Zitat Volpi P, Marinoni L, Bait C, Galli M, Denti M (2007) Lateral unicompartmental knee arthroplasty: indications, technique and short-medium term results. Knee Surg Sports Traumatol Arthrosc 15:1028–1034CrossRefPubMed Volpi P, Marinoni L, Bait C, Galli M, Denti M (2007) Lateral unicompartmental knee arthroplasty: indications, technique and short-medium term results. Knee Surg Sports Traumatol Arthrosc 15:1028–1034CrossRefPubMed
31.
Zurück zum Zitat Walton NP, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg 19:112–116PubMed Walton NP, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg 19:112–116PubMed
32.
Zurück zum Zitat White J, Kelly M, Dunsmuir R (1998) C-reactive protein level after total hip and total knee replacement. J Bone Joint Surg Br 80:909–911CrossRefPubMed White J, Kelly M, Dunsmuir R (1998) C-reactive protein level after total hip and total knee replacement. J Bone Joint Surg Br 80:909–911CrossRefPubMed
33.
Zurück zum Zitat Yang KY, Wang MC, Yeo SJ, Lo NN (2003) Minimally invasive unicondylar versus total condylar knee arthroplasty–early results of a matched-pair comparison. Singapore Med J 44:559–562PubMed Yang KY, Wang MC, Yeo SJ, Lo NN (2003) Minimally invasive unicondylar versus total condylar knee arthroplasty–early results of a matched-pair comparison. Singapore Med J 44:559–562PubMed
Metadaten
Titel
Effects of periarticular steroid injection on knee function and the inflammatory response following unicondylar knee arthroplasty
verfasst von
Yung Chuan Sean Ng
Ngai Nung Lo
Kuang Ying Yang
Shi Lu Chia
Hwei Chi Chong
Seng Jin Yeo
Publikationsdatum
01.01.2011
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 1/2011
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-010-1126-0

Weitere Artikel der Ausgabe 1/2011

Knee Surgery, Sports Traumatology, Arthroscopy 1/2011 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.