The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

The Effect of Adding Corticosteroid to the Periarticular Injection Cocktail for Pain Control after Total Hip and Total Knee Arthroplasty: A Double-Blinded Randomized Clinical Trial

Document Type : RESEARCH PAPER

Authors
Abolfazl Bagheri Fard
Mahmoud Jabalameli
Amir Mohsen Khorrami
Mohammad Taher Ghaderi
Mehdi Mohammadpour
kaveh gharanizadeh
Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
10.22038/abjs.2022.50610.2509
Abstract
Background: The impact of periarticular corticosteroid injection for pain control after total joint arthroplasty (TJA) is
controversial. The present study aimed to investigate this controversy in patients undergoing total hip arthroplasty
(THA) and total knee arthroplasty (TKA).
Methods: A total of 42 THA and 42 TKA patients were included in this study. The patients of each group were randomly
allocated into group A (cocktail+Depo-Medrol) and group B (cocktail alone). The outcome measures were a Visual
Analog Scale (VAS) for pain at five different time points for both THA and TKA, as well as the knee range of motion
(ROM) and straight leg raise (SLR) for the TKA group only. Patients were followed for three months to observe infection,
wound complications, and any venous thromboembolic event.
Results: In the THA group, the preoperative VAS, 12, 24, 48, and 72h postoperative VAS were not statistically different
between groups A and B (P=0.49, P=0.5, P=0.96, P=0.15, and P=0.11, respectively). In the TKA group, the preoperative
VAS, 12, 24 48h, and 72h postoperative VAS were not statistically different between groups A and B (P=1.0, P=0.47,
P=0.82, P=0.92, P=0.5, respectively). The mean scores of knee range of motion and ability to perform SLR were not
significantly different between TKA patients in the steroid and non-steroid groups (P=0.18 and P=0.58, respectively).
The only observed complication was one surgical site infection in the non-steroid group of the TKA.
Conclusion: The obtained results did not support the benefit of including a steroid (Depo-Medrol) in the periarticular
injection cocktail for pain control after the THA and TKA.
Level of evidence: II
Keywords
Periarticular corticosteroid injection
Postoperative pain control
Total hip arthroplasty
Total knee arthroplasty
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The Archives of Bone and Joint Surgery
Volume 10, Issue 12
December 2022
Pages 1049-1055

  • Receive Date 27 July 2020
  • Revise Date 13 September 2022
  • Accept Date 15 September 2022