J Rheumatol. 1991 Jul;18(7):984-8.

Should methotrexate be discontinued before elective orthopedic surgery in patients with rheumatoid arthritis?

Bridges SL Jr, López-Méndez A, Han KH, Tracy IC, Alarcón GS.

Source

Division of Clinical Immunology and Rheumatology, University of Alabama, Birmingham 35294.

Abstract

To determine if methotrexate (MTX) contributes to early postoperative complications, we studied 38 patients with rheumatoid arthritis (RA) who underwent elective orthopedic surgery. There were 4 complications of prosthetic joint infection or wound dehiscence or infection among 19 procedures performed on patients who continued MTX until less than 4 weeks before surgery, compared to no complications among 34 procedures performed on patients who discontinued MTX 4 weeks before surgery or who were taking no remittive agent for 3 months before surgery (p less than 0.03, Fisher's exact, 2-tailed). No demographic, clinical, laboratory, nutritional, or intraoperative differences between the 2 groups were apparent, suggesting that MTX may play a role in early postoperative complications in patients with RA. A larger, prospective trial to study this issue is warranted.

PMID:: 1920333; [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances, Grant Support

Publication Types

Research Support, U.S. Gov't, P.H.S.

MeSH Terms

Substances

Methotrexate

Grant Support

5P60-AR20614/AR/NIAMS NIH HHS/United States

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Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery. [Ann Rheum Dis. 2001]
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Cited by 3 PubMed Central articles

Risk factors for total joint arthroplasty infection in patients receiving tumor necrosis factor α-blockers: a case-control study. [Arthritis Res Ther. 2010]
Risk factors for total joint arthroplasty infection in patients receiving tumor necrosis factor α-blockers: a case-control study.
Gilson M, Gossec L, Mariette X, Gherissi D, Guyot MH, Berthelot JM, Wendling D, Michelet C, Dellamonica P, Tubach F, et al. Arthritis Res Ther. 2010; 12(4):R145. Epub 2010 Jul 16.
Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery. [Ann Rheum Dis. 2001]
Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery.
Grennan DM, Gray J, Loudon J, Fear S. Ann Rheum Dis. 2001 Mar; 60(3):214-7.
Survival and drug discontinuation analyses in a large cohort of methotrexate treated rheumatoid arthritis patients. [Ann Rheum Dis. 1995]
Survival and drug discontinuation analyses in a large cohort of methotrexate treated rheumatoid arthritis patients.
Alarcón GS, Tracy IC, Strand GM, Singh K, Macaluso M. Ann Rheum Dis. 1995 Sep; 54(9):708-12.

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