Do Corticosteroid Injections During Total Knee Replacement Improve Early Clinical Results?
Peri-articular Injections Containing a Corticosteroid During Total Knee Arthroplasty
  • Phase

  • Study Type

  • Study Participants

Prior to surgery, a pharmacist will randomly assign participating patients to one of two groups. One group will get an injection in the knee during surgery that contains medications to limit pain and an antibiotic. A second group will get an injection in the knee during surgery that contains the same pain medications and antibiotic along with a corticosteroid to control inflammation. Corticosteroids are anti-inflammatory medications, not to be confused with muscle-building anabolic steroids you may have heard about in the news. Each patient will have an equal chance of being in either of the two groups. This study will test the safety and efficacy of methylprednisolone acetate in the treatment of pain and inflammation following total knee replacement.
Information collected during your office visits:

The patient will be asked for a brief medical history so that we may determine if the patient can participate in the study. A member of our research team will ask the patient a series of questions about his/her knee. The patient will be asked to answer this series of questions a total of 4 times over the course of 1 year. Also, we will record how well the patient can bend and straighten your knee at these 4 office visits. We will have the patient rate the pain in his/her knee and ask the patient if he/she is satisfied with the surgery. If the patients have any complications, those will also be recorded. The patient will also have X-rays taken of the knee at the postoperative follow-up visits. This is the normal routine following total knee replacement. The X-rays will be read by the surgeon to help determine the success of the surgery.

Injection during total knee replacement surgery:

All patients will receive an injection containing bupivicaine HCl, morphine, epinephrine, clonidine, cefuroxime, and normal saline that will be placed directly into the knee during surgery. In addition, approximately half of the patients in the study will also receive methylprednisolone acetate as part of the injection.

Information being collected during your hospital stay:

During the hospital stay, information will be gathered for this study. A physical therapist will measure how well the patient can bend and straighten the knee. The amount of pain medication that was taken at the hospital will be recorded, and the number of days spent in the hospital will also be recorded.
Study Started
Mar 31
Primary Completion
Feb 29
Study Completion
Feb 29
Results Posted
Dec 19
Last Update
Dec 19

Drug methylprednisolone acetate

Same medications and doses as the active comparator, but with the addition of 40 mg of methylprednisolone acetate

Drug active comparator

bupivacaine HCl 80 mg, morphine 4 mg, epinephrine 300 micrograms, clonidine 100 micrograms, cefuroxime 750 mg, and normal saline

  • Other names: bupivacaine HCl, morphine, epinephrine, clonidine, cefuroxime, normal saline

Control Active Comparator

Patients in the active comparator group will receive intraoperative injections containing bupivacaine HCl, morphine, epinephrine, clonidine, cefuroxime, and normal saline, as per the surgeon's standard of care.

Corticosteroid Experimental

Patients in the Corticosteroid group will have the same medications as the Control Group with the addition of a corticosteroid (methylprednisolone acetate)


Inclusion Criteria:

Between ages of 18 and 95
Has elected to undergo total knee replacement

Exclusion Criteria:

Allergy to any of the medications used in the protocol
History of kidney disease
Rheumatoid arthritis
Any systemic conditions associated with chronic pain
History of deep knee sepsis in the affected extremity
Unable to understand the questions used to obtain the Knee Society Score
Minors and prisoners will be excluded from the study


Control Group


All Events

Event Type Organ System Event Term Control Group Corticosteroid

Length of Hospital Stay

Control Group

days (Mean)
Standard Deviation: 1.9


days (Mean)
Standard Deviation: 0.7

Knee Range of Motion

Control Group

degrees (Mean)
Standard Deviation: 10.3


degrees (Mean)
Standard Deviation: 12.1

Knee Society Scores

The Knee Society Score is on a scale of 0 to 100, with 0 being the worst possible score, and 100 being the best possible score. The Knee Society Score takes into account subjective patient reports of pain and functional ability as well as clinical measures of passive knee range of motion.

Control Group

units on a scale (Mean)
Standard Deviation: 11.2


units on a scale (Mean)
Standard Deviation: 14.7

Amount of Pain Medication Taken Per Day

Control Group

mg/day morphine equivalant (Mean)
Standard Deviation: 35.1


mg/day morphine equivalant (Mean)
Standard Deviation: 22.4

Patient Satisfaction

Outcome Measure Data Not Reported

Complications, Such as Infections, Hospital Readmissions, Manipulations Under Anesthesia, Etc.

Control Group


Number of participants with complication



Age Continuous

years (Mean)
Standard Deviation: 11.0

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Control Group