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
...reatment
...ions To CONTINUE Through SurgeryHaving trou...
...le 2. Medications To WITHHOLD Prior To S...
...ulations Included in the GuidelineHavi...
Summary of Recommendations (all are condi...
...tinue the current dose of methotrexate, le...
Withhold all current biologic agents pri...
...ithhold tofacitinib for at least 3...
...tinue the current dose of mycophenolate mof...
...d the current dose of mycophenolate mof...
...biologic therapy in patients for whom biologic...
Continue the current daily dose of glucocortico...
a See Tabl...