SynthesisMedicine2025
Efficacy of periarticular versus intravenous steroid on postoperative pain and nausea in patients undergoing total knee arthroplasty with local infiltration analgesia: A systematic review and network meta-analysis.
Synthesis in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed.
- Optimizing perioperative systemic dexamethasone use in total knee arthroplasty: a narrative review on current evidence.Knee surgery & related research · 2026Review
- Machine Learning-Based Prediction of Early Patient-Controlled Analgesia Discontinuation After Total Knee Arthroplasty: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo compare the effects of postoperative pain relief, nausea relief, and occurrence of adverse effects associated with steroid use between single-dose intravenous steroid (SDIV) and periarticular injection (PAI) of steroid after total knee arthroplasty.
methodsThis systematic review and network meta-analysis was conducted in accordance with PRISMA guidelines. Randomized controlled trials involving patients undergoing primary unilateral total knee arthroplasty with local infiltration analgesia were included. Studies comparing SDIV, PAI, or no steroid use were selected through a comprehensive search of PubMed, Embase, and the Cochrane Library (January 1990-March 2024). Non-English articles, case reports, protocols, and non-randomized controlled trials were excluded. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. A frequentist network meta-analysis was performed to synthesize data on quantitative outcomes (visual analog scale scores, range of motion, flexion angle, opioid consumption) and qualitative outcomes (postoperative nausea and vomiting [PONV], wound complications). Treatment rankings were estimated using surface under the cumulative ranking area values.
resultsCompared to the control group, both SDIV and PAI significantly reduced postoperative visual analog scale scores at rest and during activity up to postoperative day 2. On day 3, SDIV maintained superior pain relief, while PAI effects plateaued. Range of motion and flexion angle were significantly improved in both steroid groups, with PAI showing a slight advantage in early recovery. Opioid consumption was consistently lower in the steroid groups, especially with PAI. Incidence of PONV was lowest in the SDIV group, indicating superior antiemetic effects. No significant differences were observed in wound complication rates across the groups.
conclusionIn clinical practice, intravenous steroids may be considered for patients at higher risk of PONV, while periarticular steroids may be preferred for enhancing localized pain control in the early postoperative period.
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Registered trials
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.