{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:47:12Z","timestamp":1790984832361,"version":"4.1.0"},"reference-count":68,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Complete blood cell count-based ratios (CBRs), including the neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), are inflammatory markers associated with postoperative morbidity. Given the link between the surgical stress response and complications after total joint arthroplasty (TJA), this study aimed to evaluate whether higher preoperative CBR values predict greater postoperative benefits associated with dexamethasone utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The Premier Healthcare Database was queried for adult patients who underwent primary, elective total hip or knee arthroplasty (THA or TKA). Multivariable logistic regression models using dexamethasone exposure and CBRs as independent variables assessed primary end points of 90-day postoperative complications and length of stay (LOS) of \u22653 days. The probability difference between the dexamethasone and non-dexamethasone groups for each primary end point was determined across all values of each CBR. Probability differences were compared across CBR quartiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 32,849 primary, elective TJAs (12,788 THAs [38.93%], 20,061 TKAs [61.07%]) performed between 2016 and 2021 were identified, and 22,282 (67.83%) of the patients received perioperative dexamethasone. Among patients with an NLR value of &gt;1.00, those receiving dexamethasone had a lower probability of postoperative complications (all p &lt; 0.05). Dexamethasone was associated with lower odds of an LOS of \u22653 days among patients in the highest NLR quartile (\u22654.67) compared with the lowest quartile (NLR &lt;1.84) (p = 0.002). Among patients with an MLR value of \u22650.36, those receiving dexamethasone had significantly lower odds of postoperative complications. Dexamethasone was associated with lower odds of an LOS of \u22653 days among patients with an MLR of \u22650.33 (the 2 highest quartiles) compared with an MLR of &lt;0.24 (the lowest quartile) (p = 0.039).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Higher NLR and MLR values were associated with greater marginal benefit from perioperative dexamethasone treatment, establishing a modifiable link between adverse outcomes and perioperative inflammation in TJA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.24.00184","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T14:01:04Z","timestamp":1732111264000},"page":"163-173","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Complete Blood Cell Count-Based Ratios Identify Total Joint Arthroplasty Patients Likely to Benefit from Perioperative Dexamethasone"],"prefix":"10.2106","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-604X","authenticated-orcid":false,"given":"Julian","family":"Wier","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6051-4762","authenticated-orcid":false,"given":"Ian A.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5201-7371","authenticated-orcid":false,"given":"Ryan","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5268-3817","authenticated-orcid":false,"given":"Cory K.","family":"Mayfield","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4299-9348","authenticated-orcid":false,"given":"Nicholas J.","family":"Kassebaum","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1374-8929","authenticated-orcid":false,"given":"Jay R.","family":"Lieberman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1293-1702","authenticated-orcid":false,"given":"Nathanael D.","family":"Heckmann","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"issue":"1","key":"bib1-20250405","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1002\/art.23176","article-title":"National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II","volume":"58","author":"Lawrence","year":"2008","journal-title":"Arthritis Rheum."},{"issue":"2","key":"bib2-20250405","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/NOR.0b013e31824fcd42","article-title":"The impact of osteoarthritis in the United States: a population-health perspective: A population-based review of the fourth most common cause of hospitalization in U.S. adults","volume":"31","author":"Murphy","year":"2012","journal-title":"Orthop Nurs."},{"issue":"5","key":"bib3-20250405","doi-asserted-by":"crossref","first-page":"963","DOI":"10.2106\/00004623-200405000-00012","article-title":"Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature","volume":"86","author":"Ethgen","year":"2004","journal-title":"J Bone Joint Surg Am."},{"issue":"7","key":"bib4-20250405","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1136\/annrheumdis-2013-204763","article-title":"The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study","volume":"73","author":"Cross","year":"2014","journal-title":"Ann Rheum Dis."},{"issue":"3","key":"bib5-20250405","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.clim.2012.12.011","article-title":"Immunopathogenesis of osteoarthritis","volume":"146","author":"Haseeb","year":"2013","journal-title":"Clin Immunol."},{"issue":"5","key":"bib6-20250405","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s11926-013-0323-5","article-title":"Synovium and the innate inflammatory network in osteoarthritis progression","volume":"15","author":"Liu-Bryan","year":"2013","journal-title":"Curr Rheumatol Rep."},{"issue":"1","key":"bib7-20250405","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.arth.2016.06.027","article-title":"Characterizing the Acute Phase Response in Healthy Patients Following Total Joint Arthroplasty: Predictable and Consistent","volume":"32","author":"Oelsner","year":"2017","journal-title":"J Arthroplasty."},{"issue":"3","key":"bib8-20250405","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1177\/14604086211034008","article-title":"Association of the neutrophil\u2013lymphocyte ratio to patient outcomes after trauma: A systematic review","volume":"24","author":"Qiu","year":"2022","journal-title":"Trauma."},{"issue":"3","key":"bib9-20250405","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.bja.2021.04.033","article-title":"Preoperative inflammatory mediators and postoperative delirium: systematic review and meta-analysis","volume":"127","author":"Noah","year":"2021","journal-title":"Br J Anaesth."},{"issue":"1","key":"bib10-20250405","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s13018-018-0910-2","article-title":"Predictive value of lymphocyte to monocyte ratio and monocyte to high-density lipoprotein ratio for acute deep vein thrombosis after total joint arthroplasty: a retrospective study","volume":"13","author":"Zhu","year":"2018","journal-title":"J Orthop Surg Res."},{"issue":"7","key":"bib11-20250405","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/j.hlc.2019.11.021","article-title":"The Prognostic Value of Elevated Perioperative Neutrophil-Lymphocyte Ratio in Predicting Postoperative Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Meta-Analysis","volume":"29","author":"Liu","year":"2020","journal-title":"Heart Lung Circ."},{"issue":"8","key":"bib12-20250405","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1007\/s00134-002-1392-5","article-title":"Early increase of procalcitonin after cardiovascular surgery in patients with postoperative complications","volume":"28","author":"Meisner","year":"2002","journal-title":"Intensive Care Med."},{"issue":"8","key":"bib13-20250405","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1007\/s11605-016-3171-6","article-title":"C-Reactive Protein and Procalcitonin as Predictors of Postoperative Inflammatory Complications After Pancreatic Surgery","volume":"20","author":"Giardino","year":"2016","journal-title":"J Gastrointest Surg."},{"issue":"12","key":"bib14-20250405","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1007\/s00264-020-04731-6","article-title":"Combined serum biomarker analysis shows no benefit in the diagnosis of periprosthetic joint infection","volume":"44","author":"Klim","year":"2020","journal-title":"Int Orthop."},{"issue":"1","key":"bib15-20250405","doi-asserted-by":"crossref","first-page":"3284","DOI":"10.1038\/s41598-019-39150-0","article-title":"Prognostic Value of Preoperative Systemic Immune-Inflammation Index in Patients with Cervical Cancer","volume":"9","author":"Huang","year":"2019","journal-title":"Sci Rep."},{"issue":"2","key":"bib16-20250405","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1245\/s10434-018-6942-3","article-title":"Combination of the Preoperative Systemic Immune-Inflammation Index and Monocyte-Lymphocyte Ratio as a Novel Prognostic Factor in Patients with Upper-Tract Urothelial Carcinoma","volume":"26","author":"Jan","year":"2019","journal-title":"Ann Surg Oncol."},{"issue":"1","key":"bib17-20250405","doi-asserted-by":"crossref","first-page":"39482","DOI":"10.1038\/srep39482","article-title":"Systemic Immune-Inflammation Index Predicts Prognosis of Patients with Esophageal Squamous Cell Carcinoma: A Propensity Score-matched Analysis","volume":"6","author":"Geng","year":"2016","journal-title":"Sci Rep."},{"issue":"16","key":"bib18-20250405","doi-asserted-by":"crossref","first-page":"4166","DOI":"10.3390\/cancers13164166","article-title":"Prognostic Utility of Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio and Monocyte-Lymphocyte Ratio in Head and Neck Cancers: A Detailed PRISMA Compliant Systematic Review and Meta-Analysis","volume":"13","author":"Kumarasamy","year":"2021","journal-title":"Cancers (Basel)."},{"issue":"1","key":"bib19-20250405","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1186\/s12885-020-06953-8","article-title":"Combination of preoperative neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio: a superior prognostic factor of endometrial cancer","volume":"20","author":"Cong","year":"2020","journal-title":"BMC Cancer."},{"issue":"5","key":"bib20-20250405","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1053\/j.jvca.2021.07.001","article-title":"Perioperative Neutrophil-Lymphocyte Ratio Predicts Mortality After Cardiac Surgery: Systematic Review and Meta-Analysis","volume":"36","author":"Perry","year":"2022","journal-title":"J Cardiothorac Vasc Anesth."},{"issue":"8","key":"bib21-20250405","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1177\/1538574420951315","article-title":"Prognostic Significance of Preoperative Neutrophil-Lymphocyte Ratio in Vascular Surgery: Systematic Review and Meta-Analysis","volume":"54","author":"Jackson","year":"2020","journal-title":"Vasc Endovascular Surg."},{"issue":"43","key":"bib22-20250405","doi-asserted-by":"crossref","first-page":"e1867","DOI":"10.1097\/MD.0000000000001867","article-title":"Association Between the Neutrophil\/Lymphocyte Ratio and Acute Kidney Injury After Cardiovascular Surgery: A Retrospective Observational Study","volume":"94","author":"Kim","year":"2015","journal-title":"Medicine (Baltimore)."},{"key":"bib23-20250405","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ejphar.2013.10.008","article-title":"The cellular mechanisms of the antiemetic action of dexamethasone and related glucocorticoids against vomiting","volume":"722","author":"Chu","year":"2014","journal-title":"Eur J Pharmacol."},{"issue":"5","key":"bib24-20250405","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1021\/acsbiomaterials.2c00026","article-title":"Dexamethasone: Insights into Pharmacological Aspects, Therapeutic Mechanisms, and Delivery Systems","volume":"8","author":"Madamsetty","year":"2022","journal-title":"ACS Biomater Sci Eng."},{"key":"bib25-20250405","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.critrevonc.2016.03.011","article-title":"The impact of preoperative corticosteroids on the systemic inflammatory response and postoperative complications following surgery for gastrointestinal cancer: A systematic review and meta-analysis","volume":"101","author":"McSorley","year":"2016","journal-title":"Crit Rev Oncol Hematol."},{"issue":"4","key":"bib26-20250405","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1093\/bja\/88.4.496","article-title":"Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery","volume":"88","author":"El Azab","year":"2002","journal-title":"Br J Anaesth."},{"key":"bib27-20250405","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.ijsu.2018.02.043","article-title":"The efficacy of dexamethasone reducing postoperative pain and emesis after total knee arthroplasty: A systematic review and meta-analysis","volume":"52","author":"Fan","year":"2018","journal-title":"Int J Surg."},{"issue":"2","key":"bib28-20250405","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.arth.2022.08.028","article-title":"Is Intraoperative Dexamethasone Utilization Associated With Increased Rates of Periprosthetic Joint Infection Following Total Joint Arthroplasty?","volume":"38","author":"Heckmann","year":"2023","journal-title":"J Arthroplasty."},{"issue":"26","key":"bib30-20250405","first-page":"6","article-title":"Time to pay for quality. CMS will partner with premier in trial project to give financial bonuses to hospitals that deliver the best care","volume":"33","author":"Becker","year":"2003","journal-title":"Mod Healthc."},{"key":"bib32-20250405","year":"2021","journal-title":"PINC AI\u2122 Applied Sciences"},{"issue":"10","key":"bib33-20250405","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.7326\/M21-4204","article-title":"Development and Validation of the Summary Elixhauser Comorbidity Score for Use With ICD-10-CM-Coded Data Among Older Adults","volume":"175","author":"Mehta","year":"2022","journal-title":"Ann Intern Med."},{"issue":"8","key":"bib34-20250405","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.3390\/jcm11082114","article-title":"Length of Hospital Stay after Total Knee Arthroplasty: A Correlation Study on 1200 Patients","volume":"11","author":"Papalia","year":"2022","journal-title":"J Clin Med."},{"issue":"21","key":"bib35-20250405","doi-asserted-by":"crossref","first-page":"5053","DOI":"10.3390\/jcm10215053","article-title":"Preoperative and Perioperative Predictors of Length of Hospital Stay after Primary Total Hip Arthroplasty-Our Experience on 743 Cases","volume":"10","author":"Papalia","year":"2021","journal-title":"J Clin Med."},{"issue":"4","key":"bib36-20250405","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1007\/s11135-017-0584-6","article-title":"Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour","volume":"52","author":"Johnston","year":"2018","journal-title":"Qual Quant."},{"issue":"4","key":"bib37-20250405","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1111\/j.1541-0420.2006.00596_3.x","article-title":"Regression Methods in Biostatistics: Linear, Logistic, Survival, and Repeated Measures Models","volume":"62","author":"Elliott","year":"2006","journal-title":"Biometrics."},{"issue":"1","key":"bib38-20250405","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12872-022-02494-z","article-title":"The systemic-immune-inflammation index predicts the recurrence of atrial fibrillation after cryomaze concomitant with mitral valve surgery","volume":"22","author":"Luo","year":"2022","journal-title":"BMC Cardiovasc Disord."},{"issue":"11","key":"bib39-20250405","doi-asserted-by":"crossref","first-page":"308","DOI":"10.3390\/brainsci9110308","article-title":"The Practical Use of White Cell Inflammatory Biomarkers in Prediction of Postoperative Delirium after Cardiac Surgery","volume":"9","author":"Kotfis","year":"2019","journal-title":"Brain Sci."},{"issue":"12","key":"bib40-20250405","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1111\/ggi.14066","article-title":"Preoperative serum biomarkers in the prediction of postoperative delirium following abdominal surgery","volume":"20","author":"Ida","year":"2020","journal-title":"Geriatr Gerontol Int."},{"issue":"5","key":"bib41-20250405","doi-asserted-by":"crossref","first-page":"3425","DOI":"10.3390\/curroncol29050276","article-title":"Inflammatory Indexes as Predictive Biomarkers of Postoperative Complications in Oncological Thoracic Surgery","volume":"29","author":"Ginesu","year":"2022","journal-title":"Curr Oncol."},{"key":"bib42-20250405","doi-asserted-by":"crossref","first-page":"865244","DOI":"10.3389\/fnagi.2022.865244","article-title":"Systemic-Immune-Inflammation Index as a Promising Biomarker for Predicting Perioperative Ischemic Stroke in Older Patients Who Underwent Non-cardiac Surgery","volume":"14","author":"Zhang","year":"2022","journal-title":"Front Aging Neurosci."},{"key":"bib43-20250405","doi-asserted-by":"crossref","first-page":"101750","DOI":"10.1016\/j.suronc.2022.101750","article-title":"Prognostic value of pre-operative systemic immune-inflammation index and platelet to lymphocyte ratio in peritoneal carcinomatosis of ovarian origin","volume":"42","author":"Ram\u00f3n-Rodr\u00edguez","year":"2022","journal-title":"Surg Oncol."},{"key":"bib44-20250405","doi-asserted-by":"crossref","first-page":"105705","DOI":"10.1016\/j.intimp.2019.105705","article-title":"Predictive value of post-operative neutrophil\/lymphocyte count ratio for surgical site infection in patients following posterior lumbar spinal surgery","volume":"74","author":"Shen","year":"2019","journal-title":"Int Immunopharmacol."},{"issue":"12","key":"bib45-20250405","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s12032-014-0305-0","article-title":"The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients","volume":"31","author":"Ying","year":"2014","journal-title":"Med Oncol."},{"issue":"3","key":"bib46-20250405","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1007\/s00268-020-05868-6","article-title":"Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Possible Prognostic Markers for Patients Undergoing Resection of Adrenocortical Carcinoma","volume":"45","author":"de Jong","year":"2021","journal-title":"World J Surg."},{"issue":"2","key":"bib47-20250405","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/aas.14170","article-title":"The prognostic value of elevated neutrophil-lymphocyte ratio for cardiac surgery-associated acute kidney injury: A systematic review and meta-analysis","volume":"67","author":"Wheatley","year":"2023","journal-title":"Acta Anaesthesiol Scand."},{"issue":"1","key":"bib48-20250405","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.suronc.2013.12.001","article-title":"A systematic review and meta-analysis on the impact of pre-operative neutrophil lymphocyte ratio on long term outcomes after curative intent resection of solid tumours","volume":"23","author":"Paramanathan","year":"2014","journal-title":"Surg Oncol."},{"issue":"1","key":"bib49-20250405","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s13018-017-0601-4","article-title":"Perioperative systemic steroid for rapid recovery in total knee and hip arthroplasty: a systematic review and meta-analysis of randomized trials","volume":"12","author":"Yue","year":"2017","journal-title":"J Orthop Surg Res."},{"issue":"3","key":"bib50-20250405","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1016\/j.arth.2020.10.010","article-title":"Perioperative Systemic Dexamethasone Reduces Length of Stay in Total Joint Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"36","author":"Lex","year":"2021","journal-title":"J Arthroplasty."},{"issue":"19","key":"bib51-20250405","first-page":"e778","article-title":"Perioperative Dexamethasone Associated With Decreased Length of Stay After Total Hip and Knee Arthroplasty","volume":"31","author":"Yoshida","year":"2023","journal-title":"J Am Acad Orthop Surg."},{"issue":"1162","key":"bib52-20250405","doi-asserted-by":"crossref","first-page":"n1162","DOI":"10.1136\/bmj.n1162","article-title":"Effect of dexamethasone on complications or all cause mortality after major non-cardiac surgery: multicentre, double blind, randomised controlled trial","volume":"373","author":"Asehnoune","year":"2021","journal-title":"BMJ."},{"key":"bib53-20250405","doi-asserted-by":"crossref","first-page":"e067325","DOI":"10.1136\/bmj-2021-067325","article-title":"Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial","volume":"376","author":"Gasbjerg","year":"2022","journal-title":"BMJ."},{"issue":"4","key":"bib54-20250405","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s00402-021-03859-3","article-title":"Dose optimization of intravenous dexamethasone for total knee arthroplasty: when two is not better than one","volume":"142","author":"Lei","year":"2022","journal-title":"Arch Orthop Trauma Surg."},{"issue":"12","key":"bib55-20250405","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1097\/EJA.0000000000001372","article-title":"Preoperative dexamethasone for pain relief after total knee arthroplasty: A randomised controlled trial","volume":"37","author":"Chan","year":"2020","journal-title":"Eur J Anaesthesiol."},{"issue":"6","key":"bib56-20250405","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1515\/tjb-2021-0274","article-title":"Neutrophil\/lymphocyte and platelet\/lymphocyte ratios as a biomarker in postoperative wound infections","volume":"47","author":"Duran","year":"2022","journal-title":"Turkish Journal of Biochemistry."},{"issue":"10","key":"bib57-20250405","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.3390\/medicina58101502","article-title":"Inflammatory Biomarkers as Prognostic Factors of Acute Deep Vein Thrombosis Following the Total Knee Arthroplasty","volume":"58","author":"Melinte","year":"2022","journal-title":"Medicina (Kaunas)."},{"issue":"1","key":"bib58-20250405","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1186\/s12891-023-06211-5","article-title":"Predictability of Neutrophil to Lymphocyte Ratio in preoperative elderly hip fracture patients for post-operative short-term complications: a retrospective study","volume":"24","author":"Golsorkhtabaramiri","year":"2023","journal-title":"BMC Musculoskelet Disord."},{"issue":"9","key":"bib59-20250405","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.3390\/diagnostics12092033","article-title":"Diagnostic Performance of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Platelet to Mean Platelet Volume Ratio in Periprosthetic Hip and Knee Infections: A Systematic Review and Meta-Analysis","volume":"12","author":"Festa","year":"2022","journal-title":"Diagnostics (Basel)."},{"issue":"9","key":"bib60-20250405","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1016\/j.ejso.2019.05.020","article-title":"Possible dose dependent effect of perioperative dexamethasone and laparoscopic surgery on the postoperative systemic inflammatory response and complications following surgery for colon cancer","volume":"45","author":"McSorley","year":"2019","journal-title":"Eur J Surg Oncol."},{"issue":"1","key":"bib61-20250405","doi-asserted-by":"crossref","first-page":"3737","DOI":"10.1038\/s41467-020-17565-y","article-title":"Preferential inhibition of adaptive immune system dynamics by glucocorticoids in patients after acute surgical trauma","volume":"11","author":"Ganio","year":"2020","journal-title":"Nat Commun."},{"issue":"5","key":"bib62-20250405","doi-asserted-by":"crossref","first-page":"402","DOI":"10.2106\/JBJS.16.00019","article-title":"Effects of the Length of Stay on the Cost of Total Knee and Total Hip Arthroplasty from 2002 to 2013","volume":"99","author":"Molloy","year":"2017","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib63-20250405","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.bja.2017.10.011","article-title":"Current concepts of fluid management in enhanced recovery pathways","volume":"120","author":"Makaryus","year":"2018","journal-title":"Br J Anaesth."},{"issue":"4","key":"bib64-20250405","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.bpa.2020.07.003","article-title":"Clinical and economic burden of postoperative nausea and vomiting: Analysis of existing cost data","volume":"34","author":"Gress","year":"2020","journal-title":"Best Pract Res Clin Anaesthesiol."},{"issue":"3","key":"bib65-20250405","first-page":"CD011940","article-title":"Adverse side effects of dexamethasone in surgical patients","volume":"2019","author":"Polderman","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"issue":"7","key":"bib66-20250405","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1111\/anae.14610","article-title":"Adverse side-effects of dexamethasone in surgical patients - an abridged Cochrane systematic review","volume":"74","author":"Polderman","year":"2019","journal-title":"Anaesthesia."},{"issue":"18","key":"bib67-20250405","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1056\/NEJMoa2028982","article-title":"Dexamethasone and Surgical-Site Infection","volume":"384","author":"Corcoran","year":"2021","journal-title":"N Engl J Med."},{"issue":"7","key":"bib68-20250405","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/j.arth.2023.02.007","article-title":"The AAHKS Best Podium Presentation Research Award: A Second Dose of Dexamethasone Reduces Postoperative Opioid Consumption and Pain in Total Joint Arthroplasty","volume":"38","author":"Arraut","year":"2023","journal-title":"J Arthroplasty."},{"issue":"3","key":"bib69-20250405","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/imm.13320","article-title":"Monocytes, macrophages, dendritic cells and neutrophils: an update on lifespan kinetics in health and disease","volume":"163","author":"Patel","year":"2021","journal-title":"Immunology."},{"issue":"22","key":"bib70-20250405","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.1016\/j.jcin.2016.08.047","article-title":"Statistical Approaches to Composite Endpoints","volume":"9","author":"Weintraub","year":"2016","journal-title":"JACC Cardiovasc Interv."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.00184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:24:57Z","timestamp":1787750697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.00184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,20]]},"references-count":68,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.24.00184","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,20]]}}}