Corticosteroid injection during TKA manipulation under anesthesia improved range of motion
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According to published results, intra-articular corticosteroid injection for manipulation under anesthesia during total knee arthroplasty improved range of motion without increasing risk of joint infection.
Researchers performed a retrospective review of data for 209 patients (230 TKAs) who received manipulation under anesthesia with an intra-articular corticosteroid injection (IACI) during TKA. According to the study, outcome measures included prosthetic joint infection (PJI) at 3-month follow-up and range of motion (ROM) at 6-week follow-up.
At 3 months, researchers found no cases of PJI in patients who received IACI for MUA during TKA. Researchers also found patients had gained a mean 25°of arc of motion and mean 24°of flexion at 6 weeks following manipulation.
At baseline, patients had an average 111° of arc of motion and an average 113° of flexion. After the index procedure, average arc of motion was 83°and average flexion was 86° among the 158 patients who had follow-up of at least 1 year. At final follow-up, average arc of motion was 110° and an average flexion was 111°.
“Given the detrimental outcomes that may arise with PJIs, we still advise the cautious use of IACI in prosthetic knees and that all injections be performed utilizing modern sterility techniques,” the researchers wrote in the study. “We advocate for all patients presenting with a painful or stiff TKA to undergo thorough evaluation for infection prior to consideration of IACI,” they concluded.
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