Benefits of Steroid Use After Knee Arthroplasty Studied

Adding steroids to pain medications may shorten hospital stay but does not help pain or motion

MONDAY, Nov. 9 (HealthDay News) -- The injection of corticosteroids and pain relieving agents post-total knee arthroplasty may shorten hospital stay but does not seem to improve pain, range of motion or knee function as compared to injection of pain relieving agents alone, according to a study in the Nov. 1 issue of the Journal of Bone & Joint Surgery.

Christian P. Christensen, M.D., of the Lexington Clinic in Kentucky, and colleagues randomized 76 patients to post-surgery periarticular injections of pain relief agents (bupivacaine, morphine, epinephrine, clonidine and cefuroxime) or pain relief agents plus corticosteroid (methylprednisolone acetate). The researchers monitored patient pain, narcotic use, and hospital stay.

The researchers found that hospital stays were shorter for subjects receiving steroids (2.6 versus 3.5 days). However, there were no significant differences observed for pain, narcotic use, knee motion, or outcome scores. In addition, one of the patients taking steroids contracted a knee infection that led to complications and death, while two other patients required knee manipulation under anesthesia.

"The periarticular injection of a corticosteroid may reduce the length of the hospital stay following total knee arthroplasty, but it does not appear to improve pain relief, motion, or function in the early postoperative period," the authors conclude. "While we cannot definitively state that the corticosteroid was a causative factor in the development of the infection at the site of the prosthetic joint, we cannot rule it out either, which raises concern regarding the role of corticosteroids in perioperative pain management following total knee arthroplasty."

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