Medical management of patients with inflammatory arthritis undergoing total hip arthroplasty and total knee arthroplasty

Total joint arthroplasty (TJA) including total hip arthroplasty (THA) and total knee arthroplasty (TKA) are performed for patients with primary osteoarthritis (OA). Also, there are patients who undergo TJA for management of inflammatory arthritis (IA), including patients with rheumatoid arthritis (RA), Spondyloarthritis (SPA) including ankylosing spondylitis (AS) and psoriatic arthritis (PSA) and systemic lupus erythematosus (SLE).

The purpose of this review was to evaluate the current knowledge about the risk of complications after TJA in patients with IA and perioperative management of antirheumatic drugs.

THA and TKA are orthopedic surgeries that help patients with arthritis restore function, mobility and reduce pain. Patients with inflammatory arthritis have systemic disorders that cause a high rate of complications associated with the surgery.

Patients with inflammatory arthritis, including RA, SPA, and SLE who need TJA have a higher risk of developing complications compared to patients with OA.

Information about cardiovascular risk factors and other comorbidities is important to better control and reduce the risk of postoperative complications.

Abbreviations

TJA = total joint arthroplasty, THA = total hip arthroplasty, TKA = total knee arthroplasty, OA = osteoarthritis, SPA = spondyloarthritis, IA = inflammatory arthritis, RA = rheumatoid arthritis, AS = ankylosing spondylitis, PSA = psoriatic arthritis, SLE = systemic lupus erythematosus, DMARDs = Disease-modifying antirheumatic drugs, PJI = prosthetic joint infection, VTE = venous thromboembolism, HCQ = hydroxychloroquine, SSZ = sulfasalazine, TNF = tumor necrosis factor, GS = corticosteroids.