CLINICAL TRIAL article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1575417
Comparison of analgesic effects between betamethasone and dexamethasone in total knee arthroplasty: a prospective randomized controlled trial
Provisionally accepted
Kai Qin1,2,3Qunli Dou3
Bowei Li1,2Guoyang Bai1,2,3Xiaobo Sun1,2,3Jianbing Ma1,2
Chao Xu1,2*
Yuanchi Huang1,2*- 1Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, China
- 2Xi'an Jiaotong University, Xi'an, China
- 3The First Clinical College of Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
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Background: Corticosteroids such as dexamethasone and betamethasone are widely used for local infiltration analgesia in total knee arthroplasty (TKA). However, the analgesic efficacy of these two glucocorticoids in TKA cocktail therapy remains unknown. Therefore, this study aims to compare the analgesic efficacy and safety of betamethasone and dexamethasone in TKA through a prospective randomized controlled trial (RCT).Methods: A total of 120 patients were randomly assigned to three groups: Control (Con) group, Dexamethasone (Dex) group and Betamethasone (Beta) group. The primary outcome was the postoperative visual analogue scale (VAS); the secondary outcomes were the knee range of motion (ROM).Results: Compared with the Con group, the VAS scores of the Dex group during walking were decreased significantly at 12 h and 24 h postoperatively, while the Beta group showed a decrease at 12 h, 24 h, 48 h and 2 w postoperatively. In terms of dynamic VAS scores at 12 h, 24 h, 48 h and 2 w postoperatively the Beta group was superior to the Dex group. At 48 h and 2 w postoperatively , the ROM in the Beta group was better than Dex group. There were no significant differences among the three groups in terms of inflammatory markers and incidence of postoperative adverse event.Conclusion: Our prospective RCT demonstrates that betamethasone exhibits better analgesic effects than dexamethasone in the cocktail therapy of TKA and does not incur additional complications, providing a medication basis for the local application of glucocorticoids in TKA.
Keywords: Total knee arthroplasty, Cocktail therapy, Pain, Betamethasone, Dexamethasone
Received: 13 Feb 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Qin, Dou, Li, Bai, Sun, Ma, Xu and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Chao Xu, Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, China
Yuanchi Huang, Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.