The efficacy of steroid injection in total knee or hip arthroplasty.
OBJECTIVE
A systematic review and meta-analysis based on randomized controlled trials (RCTs) was conducted to evaluate the efficacy and safety of steroid injection in total knee or hip arthroplasty (TKA/THA).


METHODS
A systematical electronic search identified the relevant RCTs in the databases of PubMed, EMBASE, MEDLINE and Cochrane Central Register of Controlled Trials. Two reviewers independently completed data collection and assessment of methodological quality. Meta-analysis was performed for the outcomes of visual analogue pain score, range of motion (ROM), postoperative nausea and vomiting (PONV), morphine consumption, length of stay and complications.


RESULTS
A total of 863 participants were enrolled. Patients who received steroid injection had a significant reduction in the incidence of PONV and improvement in short-term pain score, and ROM (p < 0.05). Regarding morphine consumption and hospitalization time, the steroid group showed a significant reduction in TKA but no statistically significant difference in THA. In addition, there were no significant differences in complications (n.s.).


CONCLUSIONS
The current evidence suggests that steroid injection in TKA/THA provides short-term advantages in pain relief and antiemetic effects. The optimal dose and long-term effects of steroid injection still require numerous studies.


METHODS
II.
Orthopaedics Key Laboratory of Gansu Province, The Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730030, Gansu Province, China.
Zhaohui
Z
Cui
Department of Oncology, The First Hospital of Jilin University, Xinmin Street, Chaoyang District, Changchun City, 130000, Jilin Province, China.
Xue
X
Liu
Orthopaedics Key Laboratory of Gansu Province, The Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730030, Gansu Province, China.
Yuanjun
Y
Teng
Orthopaedics Key Laboratory of Gansu Province, The Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730030, Gansu Province, China.
Jin
J
Jiang
Orthopaedics Key Laboratory of Gansu Province, The Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730030, Gansu Province, China.
Jing
J
Wang
Orthopaedics Key Laboratory of Gansu Province, The Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730030, Gansu Province, China. plkoiujght@163.com.
Yayi
Y
Xia
D000701:Analgesics, Opioid / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D004363:Drug Utilization; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007270:Injections, Intra-Articular; D007902:Length of Stay; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control
D000701:Analgesics, Opioid; D005938:Glucocorticoids; D009020:Morphine