The Effect of Perioperative Corticosteroids in Total Hip Arthroplasty: A Prospective Double-Blind Placebo Controlled Pilot Study

摘要: Abstract Background Surgery produces a rapid rise in interleukin 6 (IL-6) which may increase the risk of deep vein thrombosis and medical complications. Perioperative corticosteroids suppress IL-6 release patients undergoing total knee arthroplasty. This study evaluates effects perioperative corticosteroid regimen on formation, thrombogenesis, fibrinolysis, clinical outcomes unilateral, uncemented, hip Methods Twenty-seven (14 placebo 13 study) were enrolled this randomized, double-blind, placebo-controlled trial. The group received 20 mg prednisone orally followed by 2 doses intravenous hydrocortisone, each 8 hours apart. Blood was drawn at several time points for IL-6, prothrombin fragment 1.2, plasmin-alpha-2-antiplasmin complex, marker fibrinolysis. In-hospital visual analog pain (visual scale) scores, patient-controlled analgesia use, ability to climb stairs recorded. Results Mean serum levels 24 postoperatively significantly lower group, whereas 1.2 not statistically different any point. Average scores similar ( P > .05), but experience less severe  = .02). At 3 months, 4 1 patient had difficulty going up down staircases .08). Conclusion use associated with significant decrease did affect thrombogenic markers. improved postoperative trend toward functional outcome months postoperatively.