The Peri-operative Management of the Rheumatoid Patient Undergoing Total Knee Arthroplasty: A Review of Literature

Mohammad Z Sohail; Nick Aresti; Sammy A Hanna; Atif A Malik; Wasim S Khan

doi:10.2174/1573397111666150522095321

The Peri-operative Management of the Rheumatoid Patient Undergoing Total Knee Arthroplasty: A Review of Literature

Curr Rheumatol Rev. 2015;11(1):34-38. doi: 10.2174/1573397111666150522095321.

Authors

Mohammad Z Sohail, Nick Aresti, Sammy A Hanna, Atif A Malik, Wasim S Khan¹

Affiliation

¹ Clinical Lecturer, University College London Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Stanmore, London, HA7 4LP, UK.

PMID: 26002451
DOI: 10.2174/1573397111666150522095321

Abstract

Rheumatoid arthritis is the commonest inflammatory arthropathy, and affects synovium, cartilage and bone. Despite recent improvements with disease modifying biological agents, progressive joint destruction may continue eventually leading to the need for joint arthroplasty. The knee joint is involved in 90% of patients with rheumatoid arthritis, and total knee arthroplasty is being performed in many patients to alleviate pain and recover function. However, complications are not uncommon. In this review of the literature we look at pre-operative, intra-operative and post-operative factor that need to be taken into account to reduce the risk of complications in these patients. Due to the systemic nature of rheumatoid arthritis, a multi-disciplinary approach is crucial. This includes addressing medical and pharmacological issues, and anesthetic concerns pre-operatively, and anticipating and preventing relevant complications postoperatively.

Keywords: Complications; management; multidisciplinary approach; rheumatoid patient; total knee arthroplasty.