• Zhengrui Fan, Jianxiong Ma, Mingjie Kuang, Lukai Zhang, Biao Han, Baocheng Yang, Ying Wang, and Xinlong Ma.
• Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin, 300050, People's Republic of China; Tianjin Hospital, Tianjin University, Tianjin, 300211, People's Republic of China; Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.
• Int J Surg. 2018 Apr 1; 52: 149-155.

BackgroundTotal knee arthroplasty (TKA) is gradually emerging as the treatment of choice for end-stage osteoarthritis. In the past, Perioperative dexamethasone treatment is still a controversial subject in total knee arthroplasty. Therefore, we write this systematic review and meta-analysis to evaluate the efficacy of dexamethasone on pain and recovery after Total knee Arthroplasty.Materials And MethodsEmbase, Pubmed, and Cochrane Library were comprehensively searched. Randomized controlled trials, cohort studies were included in our meta-analysis. Eight studies that compared dexamethasone groups with placebo groups were included in our meta-analysis. The research was reported according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Randomized controlled trials were included in our meta-analysis.ResultsOur study demonstrated that the dexamethasone group was more effective than the placebo group in term of VAS score at 24 h(P < 0.00001), 48 h(P = 0.0002); Opioid consumption (P < 0.00001); postoperative nausea (P < 0.00001); and Inflammatory factors of CPR at 24 h (P = 0.003).ConclusionOur meta-analysis demonstrated that dexamethasone decreased postoperative pain, the incidence of POVN, and total opioid consumption effectively which played a critical role in rapid recovery to TKA. However, we still need large sample size, high quality studies to explore the relationship between complications and dose response to give the final conclusion.Copyright © 2018. Published by Elsevier Ltd.

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