2026 AAHKS Annual Meeting: Oral Methylprednisolone After TKA Does Not Improve Recovery: A Randomized Controlled Trial

449 patients undergoing primary total knee arthroplasty (TKA) were randomized to receive a 6-day oral methylprednisolone taper or placebo, with 402 patients included in the final analysis (methylprednisolone: n=197; placebo: n=205). The primary outcome of interest was cumulative opioid consumption, measured in morphine milligram equivalents (MME), during the first 7 postoperative days. Secondary outcomes included pain at rest and with activity, sleep, nausea, vomiting, Knee Society Scores (KSS), and knee range of motion (ROM). Outcomes were assessed up to 6 weeks postoperatively. Overall, the results revealed no significant reduction in opioid consumption or improvement in early recovery with methylprednisolone compared to placebo. Patients receiving methylprednisolone also reported significantly greater pain and opioid consumption at 3 weeks. These findings suggested that an extended oral corticosteroid taper provided no additional clinical benefit following TKA when combined with standardized multimodal analgesia.