Glucocorticoid on Periarticular Infiltration Analgesia in To
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The aim of this systematic review and meta-analysis was to see what effect and protection multimodal cocktail protocols with or without glucocorticoids had on periarticular infiltration analgesia (PIA) in complete knee arthroplasty patients (TKA).

Researchers comprehensively searched databases for randomized controlled trials on glucocorticoids as a component of the cocktail protocol used in PIA for patients with TKA.

Results:
--11 randomized controlled trial studies with 1051 primary TKAs (930 patients) were included.

--Visual analog scale scores at postoperative day (POD) 1 and POD 2 in the glucocorticoid groups were significantly lower than those in the control group.

--Furthermore, the glucocorticoid group was associated with a statistically significant improvement in the range of motion at POD 1, reduction in total morphine consumption at 24 hours, and lower levels of C-reactive protein on POD 2/3 compared with the control group.

--However, neither the length of hospital stays nor the long-term Knee Society Knee Score showed any differences between the two groups.

--In addition, the results of subgroup analyses favored triamcinolone acetonide over betamethasone, methylprednisolone, and dexamethasone regarding the postoperative visual analog scale scores and range of motion.

Finally, in patients with unilateral or bilateral TKA, glucocorticoid supplementation in PIA is successful and does not increase complications or side effects. Triamcinolone acetonide can also be recommended for glucocorticoid supplementation in multimodal cocktail protocols.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0883540321003399?dgcid=rss_sd_all
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