Steroid Versus Non-steroid Intraoperative Multimodal Periarticular Injection in Simultaneous Bilateral Total Knee...

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis.
• Postoperative pain and limited range of motion (ROM) are significant challenges following TKA.
• Multimodal periarticular injections are used to manage pain and improve early functional recovery.

Purpose of the Study:

• To compare postoperative pain, knee flexion, and straight leg raise (SLR) outcomes between the right and left knees after simultaneous bilateral primary TKA.
• To investigate the effect of adding methylprednisolone to a multimodal periarticular cocktail injection in the right knee.

Main Methods:

• Prospective observational comparative study of 30 patients (60 knees) undergoing simultaneous bilateral primary TKA.
• Intraoperative multimodal periarticular cocktail injection administered to both knees.
• Right knee injection included methylprednisolone (80 mg); left knee received the cocktail without methylprednisolone.

Main Results:

• Significantly lower Visual Analog Scale (VAS) pain scores in the right knee compared to the left at 12, 24, 48, and 72 hours post-operation (p < 0.001).
• Significantly greater knee ROM in the right knee at 24, 48, and 72 hours post-operation (p < 0.05).
• Significantly higher active SLR values in the right knee at 24, 48, and 72 hours post-operation (p < 0.05).

Conclusions:

• Adjunctive methylprednisolone in intraoperative periarticular injections significantly improves postoperative pain after TKA.
• Methylprednisolone enhances early functional recovery, evidenced by increased ROM and SLR.
• This approach offers a promising strategy for optimizing TKA outcomes.