Meta- analysis showed that high-dose systemic steroid ( dexamethasone > 0.1 mg/kg ) rather than low dose is effective to reduce postoperative nausea and vomiting and postoperative acute pain ( within 24 h ) .
In addition , systemic steroid is associated within faster functional rehabilitation and greater inflammation control .
On the other h and , systemic steroid is associated with a higher level of postoperative serum glucose on the operation day .
Conclusions Our study suggests that by providing lower incidence of postoperative nausea and vomiting and less postoperative acute pain , high-dose systemic steroid plays a critical role in rapid recovery to TKA and THA .
The preliminary results also show the superior possibility of systemic steroid in functional rehabilitation and inflammation control .
Background Perioperative systemic steroid administration for rapid recovery in total knee and hip arthroplasty ( TKA/THA ) is an important and controversial topic .
We conducted this systematic review and meta- analysis to evaluate the overall benefits and harms of perioperative systemic steroid in patients undergoing TKA and THA .
Risk of infectious complications in patients taking glucocorticosteroids.
The association between corticosteroid therapy and subsequent infections was calculated by pooling data from 71 controlled clinical trials . The overall rate of infectious complications was 12.7 % in the 2,111 patients r and omly allocated to systemic corticosteroids  and 8.0 % in the 2,087 controls  ( relative risk [ RR ] , 1.6 ; 95 % confidence interval [ CI ] , 1.3 - 1.9 ; P less than .001 ) . The risk of infection was particularly high in patients with neurologic diseases ( RR , 2.8 ; 95 % CI , 1.9 - 4.3 ; P less than .001 ) and less pronounced in patients with intestinal ( RR , 1.4 ; 95 % CI , 1.1 - 1.7 ; P = .02 ) , hepatic ( RR , 1.4 ; 95 % CI , 0.9 - 2.3 ; P = .25 ) , and renal ( RR greater than 1 ; P = .03 ) diseases . The rate was not increased in patients given a daily dose of less than 10 mg or a cumulative dose of less than 700 mg of prednisone . With increasing doses the rate of occurrence of infectious complications increased in patients given corticosteroids as well as in patients given placebo , a finding suggesting that not only the corticosteroid but also the underlying disease state account for the steroid-associated infectious complications observed in clinical practice
Meta- analysis showed that high-dose systemic steroid ( dexamethasone > 0.1 mg/kg ) rather than low dose is effective to reduce postoperative nausea and vomiting and postoperative acute pain ( within 24 h ) .
In addition , systemic steroid is associated within faster functional rehabilitation and greater inflammation control .
On the other h and , systemic steroid is associated with a higher level of postoperative serum glucose on the operation day .
Conclusions Our study suggests that by providing lower incidence of postoperative nausea and vomiting and less postoperative acute pain , high-dose systemic steroid plays a critical role in rapid recovery to TKA and THA .
The preliminary results also show the superior possibility of systemic steroid in functional rehabilitation and inflammation control .
Background Perioperative systemic steroid administration for rapid recovery in total knee and hip arthroplasty ( TKA/THA ) is an important and controversial topic .
We conducted this systematic review and meta- analysis to evaluate the overall benefits and harms of perioperative systemic steroid in patients undergoing TKA and THA .