Erschienen in:
20.06.2019 | Original Article • KNEE - ARTHROPLASTY
Pre-operative intravenous steroid improves pain and joint mobility after total knee arthroplasty in Chinese population: a double-blind randomized controlled trial
verfasst von:
Bernadette Lok Yiu Cheng, Eric Hang Kwong So, Grace Kit Man Hui, Boogie Pui Ki Yung, Ada Sau Kwan Tsui, Oscar Kam Fung Wang, Margaret Wai Yee Poon, Andy C. M. Chan, Steven H. S. Wong, Wilson Li, Paul Sin Chuen Yip
Erschienen in:
European Journal of Orthopaedic Surgery & Traumatology
|
Ausgabe 7/2019
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Abstract
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.