An Oral Methylprednisolone Taper Within a Multimodal Analgesic Regimen After Total Knee Arthroplasty: a Double-Blind Randomized Placebo-Controlled Trial
Rush University Medical Center
Summary
The purpose of this study is to evaluate the efficacy of an oral methylprednisolone taper on acute postoperative pain, function, opioid consumption, nausea, and complications following outpatient total knee arthroplasty (TKA). We hypothesize that administration of an oral methylprednisolone taper starting on postoperative day 1 (POD 1) following TKA will be associated with improved pain and decreased opioid use, nausea, and complications at POD1-7, as compared to similar patients who receive placebo. Additionally, those taking methylprednisolone will report decreased pain and greater objective functional outcomes at 3 and 6 weeks postoperatively as compared to controls.
Description
Total knee arthroplasty (TKA) has been associated with severe pain in the acute postoperative period. Studies have demonstrated highest pain scores on POD 1 following TKA, however over 50% of patients describe the first two weeks at home as the most painful period of recovery marked by moderate to severe pain. This is an important finding as higher levels of acute pain have been associated with chronic opioid use, disturbed sleep, and impaired early mobilization, which can prolong recovery time and increase rates of adverse events, including venous thromboembolism. Therefore, extensive resear…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Any patient undergoing primary TKA with a diagnosis of osteoarthritis •≥ 18 years old * Willingness to undergo randomization Exclusion Criteria: * Reported chronic corticosteroid or opiate use * Suspected or confirmed periprosthetic joint infection * Revision TKA * Primary diagnosis other than osteoarthritis, including avascular necrosis, fracture, or post-traumatic arthritis * American Society of Anesthesiologists (ASA) score ≥ 4 * Reported history of liver disease, renal disease, or diabetes mellitus * Current systemic fungal infection or other local infection * I…
Interventions
- DrugMethylprednisolone
21 x 4mg tablets beginning on POD 1
- DrugPlacebo
21 sugar tablets beginning on POD 1 with standard management
Location
- Rush Oak Brook Outpatient CenterOak Brook, Illinois