Oral prednisolone administration in postoperative period improves results of TKA in patient with severe range of motion limitation – a paired outcome study

Abstract Background. One of the most common problems related to total knee arthroplasty (TKA) is postoperatively limited range of motion, especially in the most difficult cases. The aim of the study was to assess the influence of oral use of prednisolone in the postoperative period on the final results in a patient after TKA with severely limited postoperative range of motion.Methods. Thirty-two patients (32 knees) with a mean age of 61.2 years were selected from our prospectively-collected data base with severe knee range of motion limitation (rheumatoid arthritis, psoriasis, ankylosing spondylitis, posttraumatic and postoperative osteoarthritis). Prednisolone was administrated in two doses per day (1 mg per kg of body mass) and then the dose was slowly reduced for no more than three months. Results. The prednisolone group demonstrated significantly better results one year after the operation than the non-prednisolone group in terms of range of motion (mean extension 0.5˚ and 3.0˚; p=0.02, mean flexion 100.1˚ and 88˚; p= 0.01), WOMAC (mean 85.0 and 76.8 points; p=0.02) and KSS clinical score (mean 86.9 and 81.7; p=0.001) and KSS functional score (79.3 and 71.0 points; p=0.01). No significant differences were observed between the groups in terms of postoperative systemic and surgical site complications; therefore, no complications could be defined as steroid related. Conclusions. The administration of oral prednisolone for a longer postoperative time in patients with severe preoperative range of motion following TKA significantly improves functional results without steroid related complications at one year follow-up.