ArticleJournal of orthopaedic surgery and research2024
The effect of preoperative different dexamethasone regimens on postoperative glycemic control in patients with type 2 diabetes mellitus undergoing total joint arthroplasty: a retrospective cohort study.
Article in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 5 citations in OpenAlex.
- The effect of intraoperative dexamethasone on glycaemic responses in people with diabetes mellitus: a preplanned analysis of the Perioperative ADministration of Dexamethasone and Infection trial.British journal of anaesthesia · 2026Trial
- Clinical Study of Ultrasound-Guided Modified Percutaneous Endoscopic Interlaminar Discectomy Combined With Medical Chitosan in Lumbar 4-5 Disc Herniation Treatment.Orthopaedic surgery · 2026Trial
- Efficacy and safety of perioperative intravenous dexamethasone in type 2 diabetes mellitus patients undergoing total hip arthroplasty: a prospective randomized controlled trial.Journal of orthopaedic surgery and research · 2026Trial
- Optimizing perioperative systemic dexamethasone use in total knee arthroplasty: a narrative review on current evidence.Knee surgery & related research · 2026Review
- Intravenous Dexamethasone Administered Perioperatively vs 8 Hours Prior to Incision to Control Pain after Total Knee Arthroplasty. A Prospective Randomized Clinical Trial.Arthroplasty today · 2025Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundConcerns have been raised regarding the impact of preoperative intravenous dexamethasone on postoperative glycemic control in diabetic patients undergoing total joint arthroplasty (TJA). This study aimed to determine relationships between preoperative different dexamethasone regimens and postoperative fasting blood glucose (FBG), as well as to identify risk factors for postoperative FBG ≥ 200 mg/dl in diabetic patients undergoing TJA.
methodsThis retrospective study included 1216 diabetic patients undergoing TJA and categorized into group A (dexamethasone = 0 mg), group B (dexamethasone = 5 mg), and group C (dexamethasone = 10 mg). All dexamethasone was administered before skin incision. FBG levels were monitored until postoperative day (POD) 3. Analyses were conducted for periprosthetic joint infection (PJI) and wound complications during 90 days postoperatively. And the risk factors for postoperative FBG ≥ 200 mg/dl were identified.
resultsPreoperative dexamethasone administration resulted in a transiently higher FBG on POD 0 and POD 1 (all P < 0.001). However, no differences were observed on POD 2 (P = 0.583) and POD 3 (P = 0.131) among three groups. While preoperative dexamethasone led to an increase in postoperative mean FBG and postoperative maximum FBG (all P < 0.001), no differences were found in wound complications (P = 0.548) and PJI (P = 1.000). Increased HbA1c and preoperative high FBG, but not preoperative dexamethasone, were identified as risk factors for postoperative FBG ≥ 200 mg/dl. Preoperative HbA1c level of ≥ 7.15% was associated with an elevated risk of postoperative FBG ≥ 200 mg/dl.
conclusionsAlthough preoperative intravenous administration of 5 mg or 10 mg dexamethasone in diabetic patients showed transient effects on postoperative FBG after TJA, no differences were found in the rates of PJI and wound complications during 90 days postoperatively. Notably, patients with a preoperative HbA1c level of ≥ 7.15% and elevated preoperative FBG may encountered postoperative FBG ≥ 200 mg/dl.
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