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

Autor:	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
Předmět:	KNEE physiology POSTOPERATIVE pain prevention ANESTHESIA C-reactive protein INTRAVENOUS therapy RANGE of motion of joints LONGITUDINAL method PATIENT satisfaction PREOPERATIVE care TIME TOTAL knee replacement PAIN measurement RANDOMIZED controlled trials TREATMENT effectiveness BLIND experiment METHYLPREDNISOLONE PERIOPERATIVE care
Zdroj:	European Journal of Orthopaedic Surgery & Traumatology; Oct2019, Vol. 29 Issue 7, p1473-1479, 7p
Abstrakt:	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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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