Evidence map›Paper›PMID 37168585›Full record

ArticleThe archives of bone and joint surgery2023

Repeat High-Dose Dexamethasone May Improve Recovery 48 Hours after Total Hip Arthroplasty.

Brandon E Lung, Ryan Le, Maddison McLellan, Kylie Callan, Megan Donnelly, Justin Yi, Paramveer Birring, William C McMaster, Steven Yang, David H So

Open access · greenAbstract read
In one paragraph

Article in The archives of bone and joint surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.2field-weighted citation impact, top 13% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

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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

10 authors at 1 institution in 1 country.

Brandon E LungUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
Ryan LeUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
Maddison McLellanUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
Kylie CallanUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
Megan DonnellyUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
Justin YiUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
Paramveer BirringUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
William C McMasterUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
Steven YangUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
David H SoUniversity of California, Irvine Department of Orthopedic Surgery, Orange, CA; USA.
University of California, Irvine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Perioperative dexamethasone is an effective anti-emetic and systemic analgesic in total hip arthroplasty (THA) that may reduce opioid consumption and enhance rapid recovery. However, there is no consensus on the optimal perioperative dosing that is safe and effective for faster rehabilitation and improved pain control while maintaining safe blood glucose levels. Methods: A retrospective review of 101 primary THA patients at a single institution who received perioperative dexamethasone was conducted. Patients were stratified by dexamethasone induction dosage (10 mg as high, <6mg as low) and whether a repeat dose was given 16-24 hours postoperatively. Age, gender, BMI, diabetes status, and ASA were controlled between groups. The pain was evaluated with inpatient morphine milligram equivalents (MME) requirements and visual analog scale (VAS) at 8, 16, and 24 hours postoperatively. Mobility was assessed by inpatient ambulation distance, Boston AM-PAC mobility score, and percentage of gait assistance as determined by a physical therapist. Secondary outcomes included postoperative nausea and vomiting (PONV) limiting therapy sessions, PONV requiring breakthrough anti-emetics, glucose levels, surgical site infection, wound healing complications, and discharge destination. Results: Compared to patients receiving one dose of high or low dexamethasone, patients receiving two dosages of high-dose dexamethasone had significantly further ambulation distance and lower percentage of gait assistance on postoperative day 2. A generalized linear model also predicted that any repeat dexamethasone, regardless of dosage, significantly improved ambulation distance and gait assistance compared to the one-dose cohort. There was no statistically significant difference between VAS scores, MME requirements, PONV, postoperative glucose levels >200, discharge destination, or risk of infection between groups. Conclusion: A repeat high-dose dexamethasone, the morning after surgery, may improve percentage of gait assistance and ambulation endurance on postoperative day two. There was no risk of uncontrolled glucose levels or infections compared to receiving one dose of dexamethasone at induction.

Indexed as

DexamethasonePain controlPatient outcomesPeri-operative managementTotal hip arthroplasty

Identifiers

PMID37168585
PMCPMC10165209
OpenAlexW4376224283

What OpenQuestion holds

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Registered trials

None linked

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.