PMID- 34254696
OWN - NLM
STAT- MEDLINE
DCOM- 20220111
LR  - 20220111
IS  - 1365-2710 (Electronic)
IS  - 0269-4727 (Linking)
VI  - 46
IP  - 5
DP  - 2021 Oct
TI  - Should corticosteroids be administered for local infiltration analgesia in knee 
      arthroplasty? A meta-analysis and systematic review.
PG  - 1441-1458
LID - 10.1111/jcpt.13443 [doi]
AB  - WHAT IS KNOWN AND OBJECTIVE: The benefits of local infiltration analgesia (LIA) 
      in knee arthroplasty (KA) have been well-documented. However, it is unknown 
      whether adding a corticosteroid to the composition of the LIA is beneficial. This 
      study aimed to investigate the efficacy and safety of administering periarticular 
      steroids intraoperatively in patients who underwent KA through a systematic 
      review and meta-analysis. METHODS: A systematic search was conducted to identify 
      relevant randomized controlled trials in the PubMed, Embase, Web of Science and 
      Cochrane databases up to January 19th, 2021 to perform a meta-analysis. Outcome 
      variables included pain scores, total opioid consumption, knee range of motion 
      (ROM) and postoperative complications. RESULTS: Corticosteroid injections did not 
      reduce pain scores at 6, 12, 24 or 72 h postoperatively, although a minimal 
      degree of transient pain relief was achieved at 48 h postoperatively compared 
      with those in the placebo group, nor was there a significant difference in total 
      opioid consumption. However, patients receiving corticosteroids did exhibit a 
      transient ROM increase on postoperative days 1, 2 and 3. Since the minimal 
      clinically important difference (MCID) for ROM is unclear, it is unknown if the 
      improvement in ROM is clinically significant. WHAT IS NEW AND CONCLUSION: Our 
      specific end-point analysis demonstrated that corticosteroid administration did 
      not provide pain relief or reduce opioid consumption compared with placebo. 
      However, corticosteroids might provide a statistically significant, though 
      transient and minimal improvement in knee ROM after KA, although no firm 
      conclusions about the benefits of administering corticosteroids in KA can be made 
      based on the available evidence.
CI  - (c) 2021 John Wiley & Sons Ltd.
FAU - Huang, Le-Yi
AU  - Huang LY
AUID- ORCID: 0000-0002-1194-9129
AD  - Zhejiang University School of Medicine, Hangzhou, China.
AD  - Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, Zhejiang 
      University, School of Medicine, Yiwu, China.
FAU - Hu, Hong-Hua
AU  - Hu HH
AUID- ORCID: 0000-0002-0113-4786
AD  - Zhejiang University School of Medicine, Hangzhou, China.
AD  - Department of Dermatology, The Fourth Affiliated Hospital, Zhejiang University, 
      School of Medicine, Yiwu, China.
FAU - Zhong, Zhuo-Lin
AU  - Zhong ZL
AD  - Zhejiang University School of Medicine, Hangzhou, China.
AD  - Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, Zhejiang 
      University, School of Medicine, Yiwu, China.
FAU - Teng, Chong
AU  - Teng C
AD  - Zhejiang University School of Medicine, Hangzhou, China.
AD  - Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, Zhejiang 
      University, School of Medicine, Yiwu, China.
FAU - He, Bin
AU  - He B
AD  - Zhejiang University School of Medicine, Hangzhou, China.
AD  - Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang 
      University, School of Medicine, Hangzhou, China.
FAU - Yan, Shi-Gui
AU  - Yan SG
AD  - Zhejiang University School of Medicine, Hangzhou, China.
AD  - Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang 
      University, School of Medicine, Hangzhou, China.
LA  - eng
GR  - 2016KYB180/Medical Scientific Research Foundation of Zhejiang Province/
GR  - G18008/Foundation of Zhejiang Provincial Education Department/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210712
PL  - England
TA  - J Clin Pharm Ther
JT  - Journal of clinical pharmacy and therapeutics
JID - 8704308
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Anesthetics, Local)
SB  - IM
MH  - Adrenal Cortex Hormones/administration & dosage/*therapeutic use
MH  - Analgesics, Opioid/administration & dosage
MH  - Anesthetics, Local/administration & dosage/*therapeutic use
MH  - Arthroplasty, Replacement, Knee/*methods
MH  - Humans
MH  - Injections, Intra-Articular
MH  - Pain Management/methods
MH  - Pain, Postoperative/*drug therapy
MH  - Postoperative Complications/epidemiology
MH  - Randomized Controlled Trials as Topic
MH  - Range of Motion, Articular
OTO - NOTNLM
OT  - analgesic efficacy
OT  - corticosteroid
OT  - knee arthroplasty
EDAT- 2021/07/14 06:00
MHDA- 2022/01/12 06:00
CRDT- 2021/07/13 08:48
PHST- 2021/04/23 00:00 [revised]
PHST- 2021/03/27 00:00 [received]
PHST- 2021/05/11 00:00 [accepted]
PHST- 2021/07/14 06:00 [pubmed]
PHST- 2022/01/12 06:00 [medline]
PHST- 2021/07/13 08:48 [entrez]
AID - 10.1111/jcpt.13443 [doi]
PST - ppublish
SO  - J Clin Pharm Ther. 2021 Oct;46(5):1441-1458. doi: 10.1111/jcpt.13443. Epub 2021 
      Jul 12.