2018
DOI: 10.1186/s41927-018-0008-9
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Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review

Abstract: Total hip (THA) and total knee arthroplasty (TKA) are widely used, successful procedures for symptomatic end stage arthritis of the hips or knees, but patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and spondyloarthritis (SPA) including ankylosing spondylitis (AS) and psoriatic arthritis (PSA) are at higher risk for adverse events after surgery. Utilization rates of THA and TKA remain high for patients with RA, and rates of arthroplasty have increased for patients with SLE and SPA.… Show more

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Cited by 20 publications
(14 citation statements)
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“…We found that SS was not associated with complications including implant infection, revision or mortality after primary THA or TKA. Our nding contrasts with previously noted higher post-TKA/THA complication rates in people with other systemic in ammatory conditions, such as RA, SpA or lupus (5). Limited joint or organ involvement in SS compared to RA, SpA or lupus (20) and/or the assessment of in-hospital complications in our study (vs. all post-operative complications) may explain these differences.…”
Section: Discussioncontrasting
confidence: 99%
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“…We found that SS was not associated with complications including implant infection, revision or mortality after primary THA or TKA. Our nding contrasts with previously noted higher post-TKA/THA complication rates in people with other systemic in ammatory conditions, such as RA, SpA or lupus (5). Limited joint or organ involvement in SS compared to RA, SpA or lupus (20) and/or the assessment of in-hospital complications in our study (vs. all post-operative complications) may explain these differences.…”
Section: Discussioncontrasting
confidence: 99%
“…Total knee arthroplasty (TKA) or hip arthroplasty (THA) are the two most common arthroplasty surgeries performed for end-stage arthritis (4). Complications and healthcare utilization after arthroplasty are increased in other systemic in ammatory rheumatic disease such as RA, lupus and spondyloarthritis (5). Whether SS, which is also a systemic autoimmune disease, has a similar impact on post-arthroplasty outcomes is unknown.…”
Section: Introductionmentioning
confidence: 99%
“…Total joint arthroplasty in patients with rheumatic diseases should be performed after a multidisciplinary team consensus regarding the medication adjustment, to reduce the overall complication rate [4].…”
Section: Discussionmentioning
confidence: 99%
“…Patients with RA, SPA and SLE are at higher risk of venous thromboembolism (VTE) compared to general population [4,24]. There is an association between inflammation and thrombosis, that is why rheumatic disorders should be controlled before the surgery [4,25].…”
Section: Complicationsmentioning
confidence: 99%
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