In a new guideline released by the American College of Rheumatology and American Association of Hip and Knee surgeons, the risk of joint infection from total hip and knee replacements can be reduced with management of anti-rheumatic medications during the perioperative process.
Here are five highlights:
1. Periprosthetic joint infections are one the most common reasons for failure of hip and knee replacements.
2. The new guideline includes eight recommendations regarding when to continue, withhold and re-start medications commonly used to tread inflammatory rheumatic diseases, as well as the optimal perioperative dosing of glucocorticoids.
3. Key recommendations for reducing infection include discontinuing biologic therapy prior to surgery in patients with inflammatory arthritis and withholding tofacitinib for at least seven days prior to surgery in rheumatoid arthritis, spondyloarthritis and juvenile idiopathic arthritis patients.
4. A patient panel was included in the study along with rheumatology and orthopedic experts to ensure the guidelines adequately represented patients' concerns and preferences.
5. ACR guidelines are developed using the Grading of Recommendations Assessment, Development and Evaluation methodology.