Perioperative Management Rheumatic Diseases
Publication Date: June 20, 2022
Key Points
Key Points
- Patients with rheumatic diseases undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) are at increased risk for periprosthetic joint infection.
- Appropriate management of antirheumatic medication in the perioperative period may provide an important opportunity to mitigate risk.
- Nonbiologic disease-modifying antirheumatic drugs may be continued throughout the perioperative period in patients with rheumatic diseases who are undergoing elective THA and TKA.
- Biologic medications should be withheld as close to 1 dosing cycle as scheduling permits prior to elective THA and TKA and restarted after evidence of wound healing, typically 14 days, for all patients with rheumatic diseases.
Treatment
...eatment...
...Medications To CONTINUE Through SurgeryHavi...
...Medications To WITHHOLD Prior To S...
...lations Included in the GuidelineHavi...
...commendations (all are conditional)...
...ontinue the current dose of methotrexate...
...urrent biologic agents prior to surgery in...
...tinib for at least 3 days prior to surgery i...
Continue the current dose of mycoph...
...the current dose of mycophenolate mofetil, azathi...
Restart biologic therapy in patients...
...nue the current daily dose of glucocorticoids in...
...See Table 3...