Effect of Periarticular Injections of Triamcinolone Acetonide During Unicompartmental Knee Arthroplasty in the Perioperative Period: A Randomized Clinical Trial

Background: Unicompartmental knee arthroplasty (UKA) is a minimally invasive procedure that preserves most knee tissue, but can also cause moderate-to-severe pain. We investigated if triamcinolone acetonide (TA) addition to a “cocktail” of agents in a periarticular injection could reduce postoperative pain and the inflammatory response, and promote rapid recovery after UKA.Methods: This was a prospective randomized clinical trial undertaken from March 2018 to October 2019. Patients were divided randomly into a control group (A) and TA group (B). In group A, a 50-mL cocktail lacking TA was injected in tissue around the joint cavity. In group B, a 50-mL cocktail containing TA was injected. Primary-outcome measurements were the visual analog pain score upon rest (VASR) and exercise (VASE), morphine consumption, range of motion (RoM), level of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in venous blood at different times. Complications were also monitored.Results: Forty-five patients in group A and 46 patients in group B were assessed. At 6, 12 and 24 h postoperatively, VASR in group A was significantly higher than that in group B (P<0.05). At 6 and 12 h postoperatively, VASE in group A was significantly higher than that in group B (P<0.05). Morphine consumption in group A was significantly higher than that in group B at 0–24 h (P<0.05) and 0–48 h (P<0.05) after surgery. At postoperative day (POD)1–3, the RoM in group B was significantly higher than that in group A (P<0.05). There was a significant decrease in CRP level in group B vs. group A on POD1 (P<0.05) and POD3 (P<0.05). The ESR of group B was significantly lower than that of group B on POD3 (P<0.05) and POD5 (P<0.05). No serious complications occurred in either group.Conclusion: TA addition to a cocktail of agents for periarticular injection effectively relieved pain, improved knee-joint function, reduced the inflammatory response, did not increase risk of complications, and promoted rapid recovery after UKA.