Efficacy and Safety of Cocktail Containing High-dose Compound Betamethasone in Single-stage Revision for Treating Periprosthetic Joint Infection
Objective To investigate the efficacy and safety of using high-dose compound betamethasone in cocktail during single-stage revision for periprosthetic joint infections(PJI).Methods Our retrospective analysis included 170 PJI patients who had undergone single-stage revisions for PJI from January 2015 to December 2020,including 72 patients receiving cocktail injection containing compound betamethasone(group A)and the rest 98 patients(group B).Postoperative visual analogue scale(VAS)scores,Opioid drug demand,postoperative nausea and vomiting(PONV),and the rate of reinfection,deep vein thrombosis(DVT),pulmonary embolism(PE),and poor wound healing were compared between the two groups.Results Group A had significantly lower VAS scores than group B within 12-48 h postoperatively(P＜0.05),and no significant differences were observed after 72 h(P＞0.05).The synovial fluid white blood cell(WBC)count in group B was significantly greater than that in group A within 24 h after surgery(P＜0.05),but there was no significant difference between the two groups after 48 h(P＞0.05).C reaction protein(CRP)in group B was significantly higher than that in group A within 48 h post-surgery(P＜0.05),but there was no significant difference between the two groups after 72 h(P＞0.05).The incidence of PONV and Opioid drug usage rate in group A were significantly lower(P＜0.05).Notably,there was no statistically significant difference in the reinfection rate,the incidence of postoperative DVT,PE,and poor wound healing between the two groups(P＞0.05).Conclusion Multimodal local infiltration analgesia with compound betamethasone as an early postoperative analgesia after a single-stage revision for PJI can reduce postoperative pain,opioid consumption,and PONV,but does not impact reinfections and complications.
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