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

...eatmen...

...le 1. Medications To CONTINUE Through Su...


...ions To WITHHOLD Prior To Surgery*...


...opulations Included in the GuidelineHaving...


...ary of Recommendations (all are conditio...

...the current dose of methotrexate, leflunomide,...

...hold all current biologic agents prior to su...

Withhold tofacitinib for at least...

...the current dose of mycophenolate m...

...rrent dose of mycophenolate mofetil, azathiopri...

...rt biologic therapy in patients for whom b...

...he current daily dose of glucocorticoids in...

...See Tabl...