Clinical Report: Prednisolone May Reduce Early Pain After TKA
Overview
Low-dose oral prednisolone combined with celecoxib post-total knee arthroplasty resulted in lower early postoperative pain. However, these benefits diminished after age adjustment and were not sustained at 24 weeks.
Background
Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis, yet many patients experience persistent postoperative pain. Effective pain management strategies are essential for improving recovery and quality of life. This study investigates the role of low-dose oral prednisolone in conjunction with celecoxib for early postoperative pain relief.
Data Highlights
{'Prednisolone + Celecoxib': {'Resting Pain (1 week)': 'Specify numerical value', 'Resting Pain (2 weeks)': 'Specify numerical value'}, 'Celecoxib Alone': {'Resting Pain (1 week)': 'Specify numerical value', 'Resting Pain (2 weeks)': 'Specify numerical value'}}Key Findings
- Prednisolone led to lower resting pain scores at one and two weeks compared to celecoxib alone.
- Improvements in sleep quality and range of motion at two and four weeks favored the prednisolone group in unadjusted analyses.
- Age adjustment attenuated the benefits of prednisolone, making differences statistically insignificant.
- No sustained benefits were observed at 24 weeks, with knee function scores favoring celecoxib alone.
- No serious adverse events were reported in either treatment group.
Clinical Implications
While low-dose oral prednisolone may provide modest early pain relief after TKA, its benefits are not sustained long-term. Clinicians should consider these findings when developing postoperative pain management protocols, emphasizing the importance of multimodal approaches.
Conclusion
The use of oral prednisolone in conjunction with celecoxib may offer temporary pain relief post-TKA, but the lack of sustained benefits suggests that its routine use should be approached with caution.
References
- Knee Surgery, Sports Traumatology, Arthroscopy, 2018 -- Timing of Periarticular Injections in Total Knee Arthroplasty: Early Administration May Enhance Postoperative Pain Management Compared to Late Administration in a Randomized Controlled Study
- Strategies for Pharmacologic Management of Postoperative Pain Following Total Knee Arthroplasty, 2025 -- A Comprehensive Review of Molecular Mechanisms and Clinical Effectiveness
- A comprehensive review and meta-analysis examining the impact of intravenous dexamethasone on postoperative results in patients receiving total knee arthroplasty, 2025
- Corticosteroids in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, 2025
- Knee Surgery, Sports Traumatology, Arthroscopy — Increased Postoperative Pain Levels Observed in Younger Patients and Smokers Following Knee Arthroscopy: A Clinical and Experimental Investigation of Synovial Metabolism
- Corticosteroids in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society
- Systemic Low Dose Corticosteroid Improves Early Postoperative Knee Function and Pain Intensity in Patients Undergoing Unilateral Total Knee Arthroplasty: A Blinded Controlled Randomized Clinical Trial.
- Oral Prednisone Use Following Primary Total Knee Arthroplasty Does Not Increase Infections, but can be Associated With Higher Risk for Medical and Surgical Complications - PubMed
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