High-Dose Steroid for Knee Arthroplasty Patients Expected to Have Postoperative Pain
High-Dose Steroid for Knee Arthroplasty Patients Expected to Have Postoperative Pain
The purpose of the Study is to test a higher dose of steroids(Dexamethasone) given just prior
 to surgery in the setting of Fast-Track Knee surgery with Arthroplasty in a group of expected
 High Pain Responders and the effect on postoperative pain and postoperative inflammation.
This study compares a new High-Dose dosage of steroids in the treatment of postoperative pain
 after Knee Arthroplasty in a Fast-Track setting in a group of expected High Pain Responders.

 The investigators compare the already used dose(medium dose) with a new high dose(HD) steroid
 given as an intravenous bolus after the spinal anaesthesia has been given, but before the
 surgery starts.

 The hypothesis is that by attenuating the inflammatory response to the surgery itself by the
 steroid Dexamethasone, the investigators expect a reduction in postoperative pain upon
 ambulation 24 hours after unilateral Knee Arthroplasty.

 Patients referred to Unilateral Total KneeArthroplasty because of knee-osteoarthritis at
 Hvidovre Hospital, Capital Region of Denmark or Vejle Hospital, South Region of Denmark are
 screened and offered inclusion in the study.

 The two groups will be randomized and double blinded. One group will be treated, as the
 current guideline in the investigator's Orthopedic fast-track Arthroplasty center, with the
 medium dose of steroid (0,3 mg dexamethasone/kg bodyweight).

 The other group wil be treated with a high dose of steroid (1,0 mg dexamethasone/kg
 bodyweight).

 The patients will be monitored the first 7 days after surgery, during the admission to the
 hospital, and by a Pain-diary in the patients own home.

 Blood tests will be taken preoperatively and postoperatively to determine the effect of the
 highdose steroid on the inflammatory response.
Inclusion Criteria:

 -  Age between 40 and 90.

 -  Booked for unilateral knee-arthroplasty.

 -  Is able to take part in the investigation(selfreported pain and nausea/vomiting)

 -  Understands Danish or English, or has a translator available.

 -  Signed written consent.

 -  A daily use of 30 mg or more of morphine or morphine equivalents .

 -  A pain catastrophizing scale(PCS) score of >20.

 Exclusion Criteria:

 -  Insulin-dependent diabetes melitus.

 -  Ongoing treatment with systemic glucocorticoids or immunosuppressing treatment(apart
 from inhaled glucocorticoids).

 -  Pregnancy/Breastfeeding

 -  Allergies for the investigational drug.

 -  A history of schizophrenia or bipolar diseases, or patients with permanent use of
 antipsychotic medication.