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J Am Acad Orthop Surg. 2013 Jun;21(6):355-63. doi: 10.5435/JAAOS-21-06-355.

Lower extremity arthroplasty in patients with inflammatory arthritis: preoperative and perioperative management.

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Weill Medical College of Cornell University, Hospital for Special Surgery, New Yortk, NY, USA.


Spondylarthritis, which includes conditions such as ankylosing spondylitis and psoriatic arthritis, and rheumatoid arthritis are the most common forms of inflammatory arthritis. Joint inflammation and damage may result in the need for arthroplasty, and the surgeon must be aware of the perioperative challenges associated with these systemic diseases. In patients with inflammatory arthritis who have polyarticular disease and spinal involvement at the time of presentation for lower extremity arthroplasty, preoperative evaluation must include careful evaluation of all joints, including the cervical spine. Preoperative assessment and perioperative management must be appropriate to minimize cardiac and pulmonary complications. Finally, the perioperative management of medications used to manage inflammatory arthritis is critical because these medications may increase the risk of infection and compromise wound healing.

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