Evidence map›Paper›PMID 30232525›Full record

ArticleInternational orthopaedics2019

Infection safety of dexamethasone in total hip and total knee arthroplasty: a study of eighteen thousand, eight hundred and seventy two operations.

Markku A Vuorinen, Riku A Palanne, Tatu J Mäkinen, Jarkko T Leskinen, Heini Huhtala, Kaisa A Huotari

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Article in International orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.

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  14. [Analgesic effect of "cocktail" analgesia containing high-dose compound betamethasone after revision hip arthroplasty and the use of opioid drugs].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Markku A VuorinenDepartment of Orthopedics and Traumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. markku.vuorinen@hus.fi.ORCID 0000-0003-4249-3344
Riku A PalannePeijas Hospital, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, University of Helsinki, Vantaa, Finland.
Tatu J MäkinenDepartment of Orthopedics and Traumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Jarkko T LeskinenDepartment of Orthopedics and Traumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Heini HuhtalaFaculty of Social Sciences, University of Tampere, Tampere, Finland.
Kaisa A HuotariDepartment of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
University of Helsinki · FITampere University · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDexamethasone has been shown to prevent post-operative nausea and vomiting (PONV) and seems to reduce post-operative pain. Both factors, which can extend the hospital stay, delay rehabilitation, and impact patient satisfaction. Because of the immunosuppressive and glucose-rising effects of dexamethasone, there has been concern of its safety in arthroplasty surgery. The purpose of our study was to examine infection safety of dexamethasone in arthroplasty surgery with enough large study material to reliably detect a possible, even small, difference in infection incidence.

methodsA total of 18,872 consecutive primary and revision hip and knee arthroplasties were analyzed with data gathered from clinical information databases and a surgical site infection surveillance database with prospective data collection. Also, emergency operations due to fractures were included except for hip hemiarthroplasties.

resultsDuring the follow-up, 189 (1.0%) prosthetic joint infections (PJIs) occurred: 0.8% after primary arthroplasty and 1.9% after revision arthroplasty. Dexamethasone was used in 2922 (15.5%) operations. The PJI rate in the dexamethasone group was 1.1% (31/2922) and in the non-dexamethasone group 1.0% (161/15950), with no significant difference in the risk of PJI between the two groups (OR 1.052, 95% CI 0.715-1.548, P = 0.773).

conclusionsIn our study material, the use of a single 5-10 mg dose of dexamethasone did not increase the incidence of post-operative PJI. A low dose of dexamethasone may be safely used to prevent PONV and as part of multimodal analgesia on patients undergoing arthroplasty operation.

Indexed as

AgedArthroplasty, Replacement, HipArthroplasty, Replacement, KneeDexamethasoneFemaleGlucocorticoidsHumansIncidenceMaleMiddle AgedPostoperative Nausea and VomitingPostoperative PainProspective StudiesProsthesis-Related InfectionsDexamethasoneGlucocorticoidsCorticosteroidInfectionPONVPostoperative nauseaProsthetic joint infectionRisk factor

Identifiers

PMID30232525
OpenAlexW2889901597

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.