{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T23:45:52Z","timestamp":1789343152820,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2503104"],"award-info":[{"award-number":["2022YFC2503104"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U22A20280"],"award-info":[{"award-number":["U22A20280"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The safety and analgesic efficacy of perioperative glucocorticoids have been established for patients without rheumatoid arthritis. Therefore, our study aims to investigate whether similar benefits can be observed in patients with rheumatoid arthritis undergoing total joint arthroplasty. Specifically, we aim to explore the impact of perioperative glucocorticoid use on postoperative complications, opioid consumption, incidence of hypotension, hyperglycemia, 30\u2010day mortality, and 90\u2010day re\u2010admission in this patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Approval for the study protocol was obtained from the Medical Research Ethics Committee at Sichuan University, aligning with the principles outlined in the Declaration of Helsinki. We retrospectively analyzed a consecutive series of patients with rheumatoid arthritis who underwent total joint arthroplasty at our medical center between November 2009 and April 2021 and who were not on chronic glucocorticoid therapy before surgery. Those who received glucocorticoids at any time during hospitalization were compared to those who did not in terms of acute complications within 90\u2009days after surgery as well as postoperative rescue opioid consumption, hypotension, and hyperglycemia during hospitalization. The two groups were also compared in terms of overall duration of hospitalization, all\u2010cause mortality within 30\u2009days, and readmission for any reason within 90\u2009days. Continuous data were assessed for significance using the independent\u2010samples t test. Categorical data were assessed using the Pearson chi\u2010squared test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 849 patients included in the analysis, 598 administered perioperative glucocorticoids and 251 did not. Prior to surgery, the two groups did not differ significantly in any clinicodemographic variable that we examined. The incidence of acute postoperative complications (2.3% vs. 4.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.187) and acute postoperative infection (2.0% vs. 2.8%, <jats:italic>p<\/jats:italic>\u2009=\u20090.482) was comparable between those who received perioperative glucocorticoids and those who did not, but the former group exhibited a significantly lower incidence of rescue opioid use (17.9% vs. 44.6%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) as well as significantly lower total rescue opioid consumption (4.7\u2009\u00b1\u20092.1\u2009mg vs. 8.9\u2009\u00b1\u20094.6 mg, <jats:italic>p<\/jats:italic>\u2009&lt; 0.001). However, the two groups showed similar incidences of postoperative hypotension, hyperglycemia, 30\u2010day mortality, and 90\u2010day re\u2010admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Perioperative glucocorticoids may reduce the need for rescue opioids after total joint arthroplasty of rheumatoid arthritis patients, without increasing the incidence of acute complications, hypotension or hyperglycemia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14150","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T09:19:06Z","timestamp":1719825546000},"page":"1974-1979","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Perioperative Short\u2010Term Glucocorticoids Do Not Increase Incidence of Complications after Total Joint Arthroplasty in Patients with Rheumatoid Arthritis"],"prefix":"10.1111","volume":"16","author":[{"given":"Yahao","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongrui","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zichuan","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyu","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-4756","authenticated-orcid":false,"given":"Zongke","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.01423"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.22.01218"},{"key":"e_1_2_13_4_1","article-title":"Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial","volume":"376","author":"Gasbjerg KS","year":"2022","journal-title":"BMJ (Clinical Research Ed)"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.03.084"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-22-00232"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.10.010"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.07.065"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42140"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-2217"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.60.3.214"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11306"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.05.041"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.01.028"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14610"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex190"},{"key":"e_1_2_13_18_1","first-page":"376:e067325","article-title":"Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial","author":"Gasbjerg KS","year":"2022","journal-title":"Bmj\u2010British Medical J"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.06.031"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2017.11.019"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.04.003"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2016.11.012"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199512000-00002"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24893"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.14150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T01:40:05Z","timestamp":1722562805000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.14150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/os.14150"],"URL":"https:\/\/doi.org\/10.1111\/os.14150","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2024-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}