Oral Prednisone Use Following Primary Total Knee Arthroplasty Does Not Increase Infections, but can be Associated...

Area of Science:

• Orthopedic Surgery
• Pharmacology
• Health Outcomes Research

Background:

• Oral prednisone use is increasingly popular for pain management after total knee arthroplasty (TKA).
• Data on the risks, particularly infection, associated with postoperative prednisone use after TKA are limited.
• This study investigated the association between perioperative prednisone and complications following TKA.

Purpose of the Study:

• To test the hypothesis that perioperative prednisone use is not associated with surgical and medical complications after TKA.
• To evaluate the risks of short-term postoperative prednisone use in TKA patients.
• To determine if prednisone use increases the incidence of complications after TKA.

Main Methods:

• A national administrative claims database was used to identify 949,555 patients undergoing primary TKA.
• Patients were categorized based on acute prednisone use (within 30 days post-surgery).
• Multivariable logistic regression models adjusted for patient demographics and comorbidities to assess complication rates.

Main Results:

• Acute prednisone use was associated with higher odds of manipulation under anesthesia (OR=1.23) and lysis of adhesions (OR=1.58).
• Increased odds of acute kidney injury (OR=1.47) and pneumonia (OR=4.04) were observed in patients using prednisone post-TKA.
• No significant increase in the incidence of infection was found with acute prednisone use.

Conclusions:

• Short-term postoperative prednisone use following TKA may increase the risk of specific surgical and medical complications.
• The study found no elevated risk of infection associated with prednisone use after TKA.
• Further research is needed to define the optimal patient profile for postoperative prednisone therapy after TKA.