Perioperative Dexamethasone Is Associated With a Reduced Risk of Periprosthetic Joint Infection Following Aseptic Revision Total Hip and Knee Arthroplasty
- Journal
- Arthroplasty today (Q1)
- Published
- 27 July 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Sahil S Telang, Pranit Kumaran, Sagar Telang, Ian A Jones, Julian Wier, Andrew G Yun, et al.
- PMID
- 42564927
- DOI
- 10.1016/j.artd.2026.102100
Why clinicians should know about it
- Picked for Orthopedics and Sports Medicine (paper of the day, 8 August 2026): Perioperative dexamethasone reduces infection after revision arthroplasty
Abstract
BACKGROUND: Dexamethasone has been increasingly used perioperatively for arthroplasty procedures. However, there is limited evidence on its use and safety for revision total hip (THA) and knee arthroplasty (TKA). This study sought to assess the association between perioperative dexamethasone administration and postoperative infectious complications in patients undergoing aseptic revision THA and TKA. METHODS: Using a national healthcare database, we identified adult patients undergoing aseptic, both-component revision THA and TKA between 2016 and 2023. Patients were stratified into those treated by high- (DEX[+]) or low-use (DEX[-]) dexamethasone surgeons using k-means clustering. Mixed-effects logistic regression was used to compare the 90-day rates of periprosthetic joint infection (PJI) and composite infectious outcomes between the DEX(+) and DEX(-) cohorts. RESULTS: In total, 35,222 patients were identified who underwent aseptic revision THA (n = 12,771) and TKA (n = 22,451). When accounting for surgeon clustering and comorbidities, DEX(+) demonstrated lower odds of PJI in revision THA (1.05% vs 3.42%, adjusted odds ratio [aOR]: 0.72, 95% confidence interval [CI]: 0.53-0.978, P = .035) and revision TKA (0.74% vs 2.87%, aOR: 0.75, 95% CI: 0.56-0.99, P = .042) as well as composite infectious outcomes in the revision THA (2.60% vs 12.15%, aOR: 0.58, 95% CI: 0.48-0.71, P < .001) and revision TKA (1.66% vs 6.90%, aOR: 0.68, 95% CI: 0.56-0.83, P < .001) cohorts. CONCLUSIONS: Perioperative dexamethasone use was associated with reduced PJI and infectious risk following aseptic revision THA and TKA, supporting the routine dexamethasone administration in revision arthroplasty procedures.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.