The use of Dexamethasone in Hip and Knee arthroplasty to improve short term recovery

14 Jun 2017

Joint replacement surgery is an increasingly common procedure which uses significant hospital resources.

According to statistics reported by the Australian Orthopaedic Association National Joint Replacement Registry, there were 43,183 hip replacements and 54,277 knee replacements undertaken in Australia in 2014.

An important aspect of the surgery, which results in postoperative pain and difficulty mobilising, is the inflammation that occurs as a result of the surgery. This study, being undertaken by LGH Orthopaedic Surgeon Dr Jonathon Mulford, aims to determine whether the administration of a drug called dexamethasone, immediately prior to surgery and 24 hours later, can improve recovery time by reducing the inflammatory reaction. Dexamethasone is a study which is widely used for a number of medical conditions; it has some known side-effects and contraindications, but generally can be administered safely at the dose to be used.

The study is a double blinded randomised controlled trial which will compare the use of dexamethasone with an inactive placebo. The research team will measure outcomes related to patient symptoms (for example nausea and vomiting) and mobility post-operatively. They will also measure outcomes which relate to readiness for discharge from hospital so that they can determine whether the group of patients receiving dexamethasone are ready to be discharged earlier than those who don’t. Generally, patients are discharged 6 days after their joint replacement surgery and the research team have designed the study to be able to detect a 20% reduction (1.2 days) in hospital stay.

If the study does show a reduction in hospital stay and improved outcomes for patients, it would provide a relatively safe, low cost and simple mechanism for improving patient outcomes and reducing the use of hospital resources by this group of patients.

The study commenced in early 2016 and the research team have now recruited approximately 50 percent of the surgical patients required for the project.