Educational Objectives As a result of reading this article, physicians should be able to: 1. Identify the current evidence in regard to perioperative use of disease-modifying anti-rheumatic drugs (DMARDs) in orthopedic surgery. 2. Analyze the data to support the continuation of methotrexate during the peri-operative period. 3. Discuss the lack of data to support evidence-based guidelines on the use of other DMARDs in patients with rheumatoid arthritis in the perioperative period. 4. List the current British Society for Rheumatology guidelines in regard to TNF-α inhibitor therapy.

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