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- Title
Methylprednisolone reduces pain and decreases knee swelling in the first 24 h after fast-track unicompartmental knee arthroplasty.
- Authors
Rytter, Søren; Stilling, Maiken; Munk, Stig; Hansen, Torben; Hansen, Torben Bæk
- Abstract
<bold>Purpose: </bold>Unicompartmental knee arthroplasty (UKA) results in less operative trauma and faster patient recovery than after a conventional total knee arthroplasty. Despite an increased focus on multimodal analgesic strategies, there is still a substantial level of patient-reported pain in the early postsurgical period after UKA. The purpose of the study was to evaluate the effect of a single preoperative dose of systemic methylprednisolone on postsurgical pain after fast-track UKA.<bold>Methods: </bold>Seventy-two patients in two consecutive series undergoing unilateral UKA were included in a prospective cohort study. The patients (n = 35) in the treatment group received a single preoperative dose of systemic methylprednisolone 125 mg, whereas the control group (n = 37) did not. Outcome measures were postsurgical pain at rest and during walking, consumption of opioids for pain rescue, knee swelling and knee range of motion, and complications.<bold>Results: </bold>In the first 24 h after surgery, the treatment group had less pain at rest (p < 0.001) and during walking (p < 0.001) and less consumption of opioids (p = 0.01) in comparison with the control group. Furthermore, the treatment group had 2.2 cm less knee swelling (p = 0.02) in the first post-operative day, and better knee extension (p = 0.004), whereas knee flexion was similar (n.s.) between groups. No serious complications were associated with the treatment.<bold>Conclusion: </bold>Addition of a single preoperative dose of 125 mg systemic methylprednisolone to a multimodal analgesic regime significantly reduced postsurgical pain and opioid consumption and decreased knee swelling in the first 24 h after fast-track UKA.<bold>Level Of Evidence: </bold>Therapeutic study, Level II.
- Subjects
KNEE surgery; POSTOPERATIVE pain treatment; METHYLPREDNISOLONE; DRUG dosage; OPIOIDS; DRUG therapy; RANGE of motion of joints; THERAPEUTICS; ANTI-inflammatory agents; POSTOPERATIVE pain prevention; PREVENTION of surgical complications; ANALGESICS; ACETAMINOPHEN; AMINES; GABA; EDEMA prevention; CARBOCYCLIC acids; COMBINATION drug therapy; KNEE diseases; LONGITUDINAL method; OSTEOARTHRITIS; POSTOPERATIVE period; PREOPERATIVE care; TOTAL knee replacement; WALKING; PAIN measurement; TREATMENT effectiveness
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2017, Vol 25, Issue 1, p284
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-014-3501-8