In a randomized controlled trial of 102 patients undergoing primary unilateral total knee arthroplasty, adding low-dose oral prednisolone (10 mg daily for 2 weeks) to celecoxib reduced early postoperative resting pain and showed short-term improvements in sleep quality, knee function score, and range of motion compared with celecoxib alone; however, these benefits were attenuated and no longer statistically significant after adjustment for baseline age differences, did not consistently meet minimal clinically important difference thresholds, and were not sustained at 24 weeks, when Knee Society Score favored celecoxib alone.