A Combined Multi-Route Regimen of Multiple Low-Dose Intravenous and Periarticular Dexamethasone Improves Perioperative Outcomes After Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial.
Yanze Xia, Honghui Song, Jia Jin et al.
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In 30 seconds
This prospective, double-blind randomized controlled trial compared five low-dose perioperative dexamethasone regimens in patients undergoing primary total knee arthroplasty. The regimens used intravenous dosing, periarticular injection, both routes, or no dexamethasone. Within 72 hours, the combined pre- and postoperative intravenous plus intraoperative periarticular regimen was associated with lower pain across rest, passive flexion, and ambulation than the other active regimens, and lower rest pain than control on postoperative days 1 to 3. Dexamethasone regimens also improved early range of motion; nausea and vomiting were less frequent with intravenous-containing regimens.
Key findings
- The combined regimen reduced rest, passive-flexion, and ambulation pain compared with the other active regimens across the reported postoperative windows.
- Compared with control, combined-regimen patients had lower rest pain on postoperative days 1 to 3; periarticular-only patients had lower pain on days 1 to 2.
- Postoperative nausea and vomiting rates were lower with combined and intravenous regimens than with control or periarticular injection alone.
- Range of motion was higher in all dexamethasone groups than in control on postoperative days 1 to 3.
Why it matters
Pain, nausea and vomiting, and early mobility are important components of recovery after total knee arthroplasty. The trial suggests that low-dose dexamethasone regimens can improve several early recovery outcomes, with the combined route regimen showing broader pain benefits than the alternatives studied. These findings help clarify how route and timing may relate to short-term postoperative recovery.
What to keep in mind
The abstract reports outcomes only within 72 hours, so it does not establish longer-term effects. It provides no sample size or quantitative effect estimates.