Local Efficacy of Corticosteroids as an Adjuvant for Periarticular Cocktail Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Double-Blind Controlled Trial.

Huiming Peng,Xisheng Weng,Jin Lin,Wei Wang,Wenwei Qian,Wenda Wang,Giustino Varrassi

doi:10.1155/2021/5595095

Huiming Peng, Xisheng Weng + Show 5 more

Open Access

https://doi.org/10.1155/2021/5595095

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Abstract

Multimodal cocktail periarticular injections comprising corticosteroids are the most suggested therapy for postoperative discomfort and swelling following total knee arthroplasty (TKA). Nevertheless, previous findings cannot be applied to instances of unilateral total knee arthroplasty on bilateral knees. This randomized, prospective, double-blind, controlled clinical study examines the efficacy as well as safety of periarticular multimodal cocktail injection along or sans corticosteroids in certain situations. The 60 patients (120 knees) that experienced concurrent bilateral total knee arthroplasty were provided periarticular injections along additional betamethasone (7 mg) in the randomized knee, as well as the other knee, where corticosteroid was not administered. Key results were “pain scores at rest as well as in action” on a visual analogue scale of 11 pt. Other results included motion range, swelling of the thigh, Hospital for Special Surgery score (HSS score), and adverse effects were measured between the two sides. No statistically promising variations were found in the visual analogue scale ranking, motion range, girth of the thigh, and HSS score, as well as complications between the two sides. The impact on treatment outcomes was maintained between the knees on postoperative day 3 or at 3 months of follow-up. Multimodal periarticular injection without corticosteroid will alleviate postoperative swelling and pain. More studies are needed for the use of betamethasone as a corticosteroid in periarticular multimodal cocktail injections. This Chinese Clinical Trial Registry is registered with ChiCTR-OPC-17013503, dated 2017-11-23, available from http://www.chictr.org.cn/showproj.aspxproj=23146.

Highlights

Total knee arthroplasty is a successful alternative for the endstage joint situation [1] yet still is one of the most unpleasant [2, 3] and disgruntled interventions [4]. e magnitude of acute postsurgery pain is indicative of slow recovery [5, 6] and adverse effects [7]
Corticosteroids are amongst the oldest anti-inflammatory agents for the management of arthritis of the knee and other joints [14]
Endorsed informed consent was collected from the patient before surgery, which indicated the patient’s volunteer participation in the study

Summary

Introduction

Total knee arthroplasty is a successful alternative for the endstage joint situation [1] yet still is one of the most unpleasant [2, 3] and disgruntled interventions [4]. e magnitude of acute postsurgery pain is indicative of slow recovery [5, 6] and adverse effects [7]. Pain Research and Management experiencing knee pain will require surgery on either knee [22]. Both techniques may be carried out at the same time or one at a time. Kwon and colleagues [23] found significant positive and very short-lived effects of corticosteroids in the bilateral complete arthroplasty of the knee. There have been a small number of studies presenting bilateral complete knee arthroplasty, probably no overlapping cases have been reported. We questioned whether the introduction of corticosteroid to the multimodal periarticular combination affords some improved pain relief, functional improvement, and tolerability in patients receiving concurrent bilateral complete knee arthroplasty

Materials and Methods

Interventions

Outcome Measurements

Secondary Outcomes e secondary outcomes include the following:

Findings

Conclusions