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
Treatm...
...ations To CONTINUE Through SurgeryHaving troubl...
Table 2. Medications To WITHHOLD Pr...
...3. Populations Included in the GuidelineHaving...
...mmendations (all are conditional)...
...the current dose of methotrexate, leflunomide,...
...all current biologic agents prior t...
...d tofacitinib for at least 3 days prior to surge...
...e current dose of mycophenolate mofet...
...old the current dose of mycophenolate mofetil, aza...
...rt biologic therapy in patients for whom bi...
Continue the current daily dose of glucocor...
...See Table...