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Several studies evaluating the patients undergoing joint replacement have found elevation in the levels of cytokine interleukin-6(IL-6). High level of IL-6 after the major surgeries have been linked to postoperative fever, confusion, pain, acute respiratory distress syndrome, fat embolism syndrome. Pre and post-operative administration of low dose steroid (Inj. Hydrocortisone 100mg) in patients undergoing TKR has shown to reduce the inerleukin-6 level and its complications. The purpose of this study was to observe the effect of intravenous hydrocortisone on cytokine Interleukin-6 (IL-6) as primary outcome and also to observe presence of Fever, Blood sugar level (BSL), Pain score (using Visual analogue scale), Range of motion (ROM) and Spo2 (Saturation of oxygen) as a secondary outcome in the patients undergoing unilateral total knee arthroplasty. In our study 30 Patients were randomized into 2 groups. The study group received first dose of injection hydrocortisone 100mg I.V at the start of surgery followed by two more doses given eight hours apart while the control group received 100 ml of NS at similar intervals. From this study, we conclude that a low dose of hydrocortisone given for a short period of over 24 hours perioperatively to the patients having unilateral total knee arthroplasty are associated with decreased level of inflammatory marker, the cytokine Interleukin-6 (IL-6). The benefits included decrease pain scores, better saturation of oxygen (Spo2), lower prevalence of fever and better range of motion.

A prospective randomized pilot study of steroid modulation of cytokine (Interleukin 6) release in unilateral total knee replacement surgeries