Perioperative Dexamethasone is Associated With a Decreased Risk of Pulmonary Embolism and Deep Vein Thrombosis Following Total Joint Arthroplasty: An Analysis of 70,000 High-Risk Patients

Gettleman, Brandon S.; Liu, Kevin C.; Yoshida, Brandon; Vega, Andrew N.; Kusnezov, Nicholas; Lieberman, Jay R.; Heckmann, Nathanael D.

doi:10.1016/j.arth.2024.05.020

The Journal of Arthroplasty

2024

DOI: 10.1016/j.arth.2024.05.020

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Perioperative Dexamethasone is Associated With a Decreased Risk of Pulmonary Embolism and Deep Vein Thrombosis Following Total Joint Arthroplasty: An Analysis of 70,000 High-Risk Patients

Brandon S. Gettleman,

Kevin C. Liu,

Brandon Yoshida

et al.

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Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty

Palmer,

Jones,

Sculco

et al. 2024

JBJS Reviews

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» Perioperative corticosteroids are strongly recommended for reducing the incidence and severity of postoperative nausea and vomiting following elective total hip or total knee arthroplasty.» Corticosteroids may reduce postoperative pain and opioid requirements. Similarly, corticosteroids appear to have a neutral-to-positive effect on length of stay, venous thromboembolism, mobility, delirium, acute kidney injury, and bone cement implantation syndrome (i.e., decreased length of stay).» Perioperative corticosteroids may induce hyperglycemia among both diabetic and nondiabetic patients; however, there is no strong evidence indicating that these transient corticosteroid-induced glycemic derangements may increase the risk of postoperative infectious complications.» The dosage and frequency of perioperative corticosteroid administration play a critical role in optimizing postoperative outcomes, with higher doses showing promise in reducing opioid consumption, postoperative pain, and length of stay.» The optimal dosage and frequency of corticosteroids remain unclear; however, the perioperative administration of 8 to 16 mg dexamethasone, or equivalent steroid, appears reasonable and safe in most cases.

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Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty

Palmer,

Jones,

Sculco

et al. 2024

JBJS Reviews

View full text Add to dashboard Cite

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Perioperative Dexamethasone is Associated With a Decreased Risk of Pulmonary Embolism and Deep Vein Thrombosis Following Total Joint Arthroplasty: An Analysis of 70,000 High-Risk Patients

Cited by 1 publication

References 33 publications

Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty

Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty

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