Perioperative Management of the Rheumatoid Patient

Clin Podiatr Med Surg. 2019 Jan;36(1):115-130. doi: 10.1016/j.cpm.2018.08.005. Epub 2018 Oct 25.

Abstract

Rheumatoid arthritis is a complex disease state with multiple associated comorbidities. Perioperative evaluation of the rheumatoid patient from a multidisciplinary approach is necessary to achieve favorable outcomes. A complete history and physical, laboratory, cervical, cardiovascular, pulmonary, and medication assessment before surgery should be performed. Educating the patient on potential complications, such as wound dehiscence, infection, and venous thromboembolism, as well as general postoperative expectations, is essential when evaluating the rheumatoid patient for surgery.

Keywords: DMARDs; Methotrexate; Perioperative management; Rheumatoid arthritis.

Publication types

  • Review

MeSH terms

  • Ankle / surgery
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / epidemiology
  • Comorbidity
  • Female
  • Foot / surgery
  • Humans
  • Male
  • Orthopedic Procedures / adverse effects*
  • Orthopedic Procedures / methods
  • Perioperative Care / methods
  • Podiatry / methods
  • Postoperative Complications / prevention & control*
  • Preoperative Care / methods*
  • Prognosis
  • Risk Assessment
  • Surgical Wound Infection / prevention & control
  • Treatment Outcome
  • Venous Thromboembolism / prevention & control

Substances

  • Antirheumatic Agents