Evidence map›Paper›PMID 40630814›Full record

ReviewThe archives of bone and joint surgery2025

Periarticular Versus Intravenous Corticosteroids in Total Knee Arthroplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Ralph Maroun, Mohammad Daher, Jonathan Liu, Alan H Daniels, Thomas J Barrett, Mouhanad M El-Othmani

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The archives of bone and joint surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
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.

Ralph MarounDepartment of Orthopaedic Surgery, Lebanese University, Beirut, Lebanon.
Mohammad DaherDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Jonathan LiuDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Alan H DanielsDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Thomas J BarrettDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Mouhanad M El-OthmaniDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Despite the extensive research revolving around total knee arthroplasty (TKA), the optimal steroid administration route remains unclear. This study aimed to compare the clinical efficacy of intravenous (IV) to periarticular (PA) steroid administration in TKA. Methods: Embase, PubMed, Cochrane, and Google Scholar were searched till April 2024 for randomized controlled trials (RCT) comparing IV to PA steroids in TKA. Each trial was assessed using the Cochrane risk-of-bias tool and classified as having a High, Low, or Unclear risk of bias. The clinical outcomes of interest were post-operative pain (reported as the Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS)), vomiting, post-operative range of motion (reported as knee flexion angle), post-operative IL-6 and CRP, and glucose levels. Post-operative complications such as surgical site or deep infections, and wound dehiscence following TKA were also recorded and assessed. Results: Five RCTs with a total of 501 patients were included in this review. There were no significant differences in pain at rest on post-operative day (POD) 1 and 2 and during activity between PA and IV administration, while pain at rest on POD 3 was lower in the PA group (I2 =38% SMD=-0.27; 95% CI: -0.5, -0.04, P=0.02). Post-operative complications, knee flexion, and laboratory values such as IL-6, CPR, and glucose showed no significant difference between the groups, while vomiting rates were significantly higher in the PA group (I2= 0% OR=2.43; 95% CI: 1.36-4.35, P=0.003). Conclusion: PA and IV peri-operative administration of glucocorticoids in TKA have similar clinical outcomes in inflammation reduction, knee flexion function, adverse event rates, and post-operative pain at rest during the first 48 hours post-operatively and at activity, while the PA group is associated with lower pain at rest on POD 3 and a higher rate of post-operative vomiting.

Indexed as

Intravenous administrationsKnee arthroplastyKnee jointPeriarticular administrationsSteroids

Identifiers

PMID40630814
PMCPMC12232571

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.