Perioperative Management Rheumatic Diseases

Last updated June 22, 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

...Tre...

...ations To CONTINUE Through Surgery...


...ble 2. Medications To WITHHOLD Pri...


...e 3. Populations Included in the Guideline...


...Summary of Rec...

...e current dose of methotrexate, lefl...

...ld all current biologic agents prio...

Withhold tofacitinib for at least 3 days prior...

...tinue the current dose of mycophenolate...

...thhold the current dose of mycophenolate mofetil...

...c therapy in patients for whom bio...

...current daily dose of glucocorticoids in adult...

...See Table...