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Intravenous hydrocortisone reduces inflammatory response with bilateral TKR
Investigators reported a significant decrease in levels of interleukin-6 and inflammation in patients with bilateral total knee replacement (TKR) after they received intravenous hydrocortisone, according to this study.
Concerned that patients undergoing bilateral TKR might show increased interleukin-6 (IL-6) levels associated with acute respiratory distress syndrome, postoperative confusion, and fever, the investigators enrolled 34 patients in a prospective, double-blinded, randomized controlled trial. They gave 17 patients three doses of hydrocortisone 8 hours apart and gave 17 patients placebo at similar intervals and monitored IL-6 and desmosine levels in all the patients, according to the abstract.
“Hydrocortisone (100 mg) given over three doses, each eight hours apart, decreased and maintained a lower degree of inflammation with bilateral total knee replacement as measured by IL-6 level,” Kethy M. Jules-Elysee, MD, and colleagues stated in the study abstract. “Corticosteroids decreased the prevalence of fever, lowered visual analog pain scores, and improved knee motion. The significantly lower values of desmosine in the study group suggest that this treatment may be protective against lung injury.”
The hydrocortisone group showed the highest IL-6 levels 24 hours after administration. There were significantly higher levels of desmosine at 24 hours in the control group, while desmosine levels in the hydrocortisone group were unchanged, according to the abstract. In addition, study results showed pain scores were significantly lower in the steroid group.
Disclosure: Jules-Elysee has no relevant financial disclosures.