Management of perioperative main risks for total joint arthroplasty in patients with rheumatoid arthritis

doi:10.3969/j.issn.2095-4344.2015.53.019

Abstract

Abstract:

BACKGROUND: Patients with rheumatoid arthritis have high cardiovascular disease risks and postsurgical complications such as postoperative infection and wound healing problems in the process of total joint arthroplasty.
OBJECTIVE: To retrospectively review the peri-operative risks when undergoing total joint replacement in patients with rheumatoid arthritis, and assess these risks, propose solutions to guide clinical practice for better peri-operative management.
METHODS: The studies related with perioperative cardiovascular risk, the risk of infection of total joint replacement were retrieved by the first author from PubMed database, GOOGLE academic database, CNKI database, Wanfang database, VIP database from 2000 to 2015 through computer. The key words in English and Chinese were respectively “Rheumatoid arthritis, Total joint arthroplast, Perioperative management, Infection, Postsurgical complications, Corticosteroid, Disease modifying antirheumatic drugs, Biologics”. Old and repetitive
studies were excluded.

RESULTS AND CONCLUSION: A total of 97 articles were retrieved. Totally 53 articles which content was inconsistent with the research themes were excluded, and 44 papers were included in the analysis. We should make a comprehensive cardiovascular examination for the patients with rheumatoid arthritis before operation. If the cardiovascular disease of the patient is unstable, this condition should be clarified and treated appropriately before surgery, otherwise, patients need to check heart function, and predict the operation risk; We should reasonably arrange the anti-rheumatism medicines and corticosteroid during perioperative, so as to make a balance between reducing postoperative infection and preventing the condition relapse; Because rheumatoid arthritis often easy to erode the cervical spine, we should conduct routine imaging examination for the patients before total joint replacement. Movement should be gentle when general anesthesia was needed.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

CLC Number:

R318

Gao Zhan-wang, Zhen Ping. Management of perioperative main risks for total joint arthroplasty in patients with rheumatoid arthritis[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(53): 8664-8669.

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