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The Role of Dexamethasone in Total Knee Arthroplasty: Effects of Oral and Intravenous Administration on Early Postoperative Pain and Mobilization (TKA)
This prospective observational cohort study aims to evaluate the association between perioperative dexamethasone administration and early postoperative recovery following primary total knee arthroplasty. In routine clinical practice, dexamethasone may be administered orally, intravenously, or not administered, depending on the surgeon's established perioperative protocol. The primary objective is to assess early postoperative recovery in terms of pain intensity, functional mobility, and knee joint range of motion. Secondary objectives include evaluation of inflammatory response, postoperative metabolic changes, opioid requirement, and the severity of postoperative nausea and vomiting (PONV). Group allocation is non-randomized and determined solely by the standard perioperative management approach routinely applied by the surgeon selected by the patient. No additional interventions are introduced for research purposes. All outcomes are assessed prospectively during the early postoperative period.
Details
| Lead sponsor | Haseki Training and Research Hospital |
|---|---|
| Status | NOT_YET_RECRUITING |
| Enrolment | 99 |
| Start date | 2026-03-31 |
| Completion | 2026-08 |
Conditions
- Knee Osteoarthritis
- Gonarthrosis; Primary
- Total Knee Arthroplasty
Interventions
- Routine perioperative management
Primary outcomes
- Postoperative Pain Intensity Measured with Visiual Analog Scale (VAS) — Measuring once in the preoperative period and every 6 hours during the first 48 hours after surgery.
Postoperative pain intensity will be assessed using the Visual Analog Scale (VAS), a validated 0 to 10 numeric rating scale, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores represent greater pain intensity and therefore a worse outcome. Pain will be evaluated both at rest and during ambulation. - Functional Mobility (Timed Up and Go Test) — Preoperatively and daily during the first 2 postoperative days.
Functional mobility will be evaluated using the Timed Up and Go (TUG) test, which measures the time (in seconds) required for a participant to stand up from a seated position, walk three meters, turn, walk back, and sit down. Shorter completion times indicate better functional mobility, whereas longer times indicate poorer performance. - Nausea and Vomiting (PONV) Score — Assessed daily during the first 2 postoperative days.
Severity of postoperative nausea and vomiting will be assessed using a 0 to 10 Numeric Rating Scale (NRS), where 0 indicates no symptoms and 10 indicates the most severe nausea or vomiting imaginable. Higher scores represent worse symptoms. - Postoperative Opioid Requirement — During the first 48 hours after surgery.
Requirement for rescue opioid analgesia following routine postoperative analgesic protocol consisting of scheduled paracetamol (4 doses per day) and NSAIDs (2 doses per day). Total opioid consumption and proportion of patients requiring opioid analgesia will be recorded. Cumulative tramadol dose administered as rescue analgesia will be recorded in milligrams (mg) during the first 48 hours after surgery. Higher values indicate greater postoperative analgesic requirement.
Countries
Turkey (Türkiye)