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· DOS Abstracts
Methylprednisolone reduce pain and decrease
knee swelling in the first 24 hours after fast-track
Oxford unicompartmental knee arthroplasty
Søren Rytter, Maiken Stilling, Stig Munk, Torben Bæk Hansen
Department of Orthopedics , Holstebro Regional Hospital, Hospital Unit West,
Denmark
Background:
Unicompartmental knee arthroplasty (UKA) operated with mini-
mal invasive surgery (MIS) results in less operative trauma and faster patient
recovery than after a conventional total knee arthroplasty. Despite an increased
focus on multimodal analgesic strategies there is still a substantial level of pa-
tient-reported pain in the early post-surgical period after MIS UKA.
Purpose / Aim of Study:
The purpose of the study was to evaluate the effect
of a single preoperative dose of systemic methylprednisolone (MP) on acute
post-surgical pain after fast-track MIS Oxford UKA.
Materials and Methods:
72 patients in 2 consecutive series undergoing uni-
lateral UKA were included in a prospective cohort study. Patients (n=35) in the
treatment group received a single preoperative dose of systemic MP 125 mg
whereas the control group (n=37) did not. Otherwise there was no difference
in the operative and postoperative treatment. Outcome measures were post-
surgical pain at rest and during walking, consumption of opioids for pain rescue,
knee swelling and knee range of motion. Complications were monitored until 4
months after surgery.
Findings / Results:
In the first 24 hours after surgery the MP group had less
pain at rest (p=0.000) and during walking (p=0.000), and less consumption of
opioids (p=0.01) in comparison with the control group. Furthermore, the MP
group had 2.2 cm less knee swelling (p=0.02) in the 1st postoperative day, and
also better (p=0.004) knee extension, whereas flexion was similar (p>0.68) be-
tween groups. No serious complications were associated with the treatment.
Conclusions:
A single preoperative dose of 125 mg systemic MP significantly
reduce post- surgical pain and opioid consumption and decrease knee swelling
in the first 24 hours after fast-track MIS Oxford UKA.
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