Abstract
Purpose
The purpose of this study is to compare the results of total knee arthroplasty between non-adrenal insufficiency group and adrenal insufficiency group undergoing steroid replacement during surgery
Patients and Methods
89 patients (89 knees) treated with TKA were enrolled in this study. We classified the patients with adrenal insufficient(AI) group and nonadrenal insufficient (NAI) group by preoperative adrenal function. Levels of serum cortisol, adrenocorticotropic hormone(ACTH), and ACTH stimulation test were checked preoperatively. Hydrocortisone 50∼75 mg was injected to adrenal insufficient group at 7:00 AM and 4:00 PM on operative day and the following day. We evaluated the range of motion, the knee society knee score and function score at preoperatively and 2 years follow up, and compared the results between NAI group and AI group.
Results
In total of 89 patients, NAI group was 53(60%) patients and AI group were 36(40%) patients. In the AI group the knee society score (KSS) improved from 49.8 to 86.8 and the knee society functional score (KSFS) from 42.6 to 89.5 at 2 years follow-up. In the NAI group, KSS rose from 51.9 to 84.3 and KSFS from 49.4 to 88.6 during the same period. In AI group, there were no postoperative complication to include mortality, infection, clinical DVT, perioperaive fracture except skin lesions during operation or postoperatively. There was a case of rupture of quadriceps tendon on the 10th postoperative day which was treated with primary repair.
Conclusion
Based on our study, there was no increased operative and postoperative complications except skin lesions in patients with adrenal insufficiency treated perioperatively with steroids.
