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
...atment...
...e 1. Medications To CONTINUE Through Surgery...
...able 2. Medications To WITHHOLD Pr...
...able 3. Populations Included in the GuidelineHa...
...of Recommendations (all are conditi...
...tinue the current dose of methotrexa...
...l current biologic agents prior to surg...
...thhold tofacitinib for at least 3 days prior to su...
...tinue the current dose of mycophenolate...
...he current dose of mycophenolate mof...
...biologic therapy in patients for whom bio...
...e the current daily dose of glucocorticoids...
...See Table 3