Effect of Methylprednisolone in Periarticular Infiltration for Primary Total Knee Arthroplasty on Pain and Rehabilitation.
Aged
Arthroplasty, Replacement, Knee
/ rehabilitation
Epinephrine
/ therapeutic use
Female
Humans
Ketorolac
/ therapeutic use
Knee Joint
/ surgery
Male
Methylprednisolone
/ therapeutic use
Middle Aged
Osteoarthritis, Knee
/ surgery
Pain Management
/ methods
Pain, Postoperative
/ surgery
Patient Satisfaction
Prospective Studies
Range of Motion, Articular
Ropivacaine
/ therapeutic use
Treatment Outcome
Visual Analog Scale
methylprednisolone
periarticular infiltration
postoperative pain
range of motion
total knee arthroplasty
Journal
The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
12
02
2019
revised:
08
04
2019
accepted:
26
04
2019
pubmed:
4
6
2019
medline:
29
9
2020
entrez:
4
6
2019
Statut:
ppublish
Résumé
Optimal pain management after total knee arthroplasty (TKA) is important to ensure timely rehabilitation and patient satisfaction. This study examines the efficacy of adding corticosteroid in periarticular infiltration cocktail with relation to postoperative pain management and rehabilitation in patients undergoing simultaneous bilateral TKA. Fifty patients with symptomatic end-stage bilateral knee osteoarthritis undergoing bilateral TKA under the same anesthetic were recruited. More painful knee was operated first, and the study solution containing ropivacaine, clonidine, epinephrine, and ketorolac with methylprednisolone was infiltrated in one knee and an identical mixture but without methylprednisolone was infiltrated in the second knee. Outcome measures included comparison of visual analogue scale on movement of each knee and range of motion achieved during the first three days after surgery. Differences in visual analogue scale score and range of motion at day one and three between the two groups of knees were significant (P < .05). Postoperative inflammation and the ability to straight leg raise showed better trends in the knees receiving prednisolone although this did not reach statistical significance. Addition of methylprednisolone to periarticular infiltration cocktail for patients undergoing TKA has significant influence on reduction of pain in the early postoperative period and patients are able to regain knee flexion more quickly.
Sections du résumé
BACKGROUND
BACKGROUND
Optimal pain management after total knee arthroplasty (TKA) is important to ensure timely rehabilitation and patient satisfaction. This study examines the efficacy of adding corticosteroid in periarticular infiltration cocktail with relation to postoperative pain management and rehabilitation in patients undergoing simultaneous bilateral TKA.
METHODS
METHODS
Fifty patients with symptomatic end-stage bilateral knee osteoarthritis undergoing bilateral TKA under the same anesthetic were recruited. More painful knee was operated first, and the study solution containing ropivacaine, clonidine, epinephrine, and ketorolac with methylprednisolone was infiltrated in one knee and an identical mixture but without methylprednisolone was infiltrated in the second knee. Outcome measures included comparison of visual analogue scale on movement of each knee and range of motion achieved during the first three days after surgery.
RESULTS
RESULTS
Differences in visual analogue scale score and range of motion at day one and three between the two groups of knees were significant (P < .05). Postoperative inflammation and the ability to straight leg raise showed better trends in the knees receiving prednisolone although this did not reach statistical significance.
CONCLUSION
CONCLUSIONS
Addition of methylprednisolone to periarticular infiltration cocktail for patients undergoing TKA has significant influence on reduction of pain in the early postoperative period and patients are able to regain knee flexion more quickly.
Identifiants
pubmed: 31155459
pii: S0883-5403(19)30449-8
doi: 10.1016/j.arth.2019.04.060
pii:
doi:
Substances chimiques
Ropivacaine
7IO5LYA57N
Methylprednisolone
X4W7ZR7023
Epinephrine
YKH834O4BH
Ketorolac
YZI5105V0L
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1646-1649Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.