Charnley Low-friction Arthroplasty in Patients with Psoriasis

Menon, Trisha; Wroblewski, B. M.

doi:10.1097/00003086-198306000-00016

Cited by 33 publications

(25 citation statements)

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“…One report of 55 arthroplasties suggested that psoriasis patients were at a significantly increased risk for post-operative infection vs. patients with rheumatoid or osteoarthritis. 70 Similar findings have also been reported with knee arthroplasty. 71 Finally, the largest published case-control study available suggests that psoriasis is a risk factor for post-operative infection in hip replacement surgery but not knee replacement surgery.…”

Section: Infectionsupporting

confidence: 73%

National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

Kimball

Gladman

Gelfand

et al. 2008

Journal of the American Academy of Dermatology

382

321

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Section: Infectionsupporting

confidence: 73%

National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

Kimball

Gladman

Gelfand

et al. 2008

Journal of the American Academy of Dermatology

382

321

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“…Other adverse events increased in patients with SLE include deep venous thrombosis (DVT) and pulmonary embolism (PE), and major acute coronary events (MACE), although patients with RA do not have an increased risk for VTE or MACE after arthroplasty [19,20]. While the recent literature addressing adverse events in patients with SPA is sparse, increased inpatient complications including VTE and cardiac complications have been described using the Agency for Healthcare Research and Quality National Inpatient Sample, a large publically available inpatient database [21], while older studies have demonstrated an increase in infection for patients with PSA undergoing arthroplasty, but have not been repeated since the use of prophylactic perioperative antibiotics became widespread [22,23]. For patients with RA, the RA specific experience of the surgeon or surgical team decreases the risk of adverse surgical events, but the volume-outcome relationship with SLE or SPA specific volume has not been described [24].…”

Section: Introductionmentioning

confidence: 99%

Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review

Goodman

Bass

2018

BMC Rheumatol

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Total hip (THA) and total knee arthroplasty (TKA) are widely used, successful procedures for symptomatic end stage arthritis of the hips or knees, but patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and spondyloarthritis (SPA) including ankylosing spondylitis (AS) and psoriatic arthritis (PSA) are at higher risk for adverse events after surgery. Utilization rates of THA and TKA remain high for patients with RA, and rates of arthroplasty have increased for patients with SLE and SPA. However, complications such as infection are increased for patients with SLE, RA, and SPA, most of whom are receiving potent immunosuppressant medications and glucocorticoids at the time of surgery. Patients with SLE and AS are also at increased risk for perioperative cardiac and venous thromboembolism (VTE), while RA patients do not have an increase in perioperative cardiac or VTE risk, despite an overall increase in VTE and cardiac disease. This narrative review will discuss the areas of heightened risk for patients with RA, SLE, and SPA, and the perioperative management strategies currently used to minimize the risks.

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“…Furthermore, the overall revision rate was notably higher in the patients with psoriatic arthritis versus those with either RA or osteoarthritis. Similarly, Menon and Wroblenski demonstrated higher deep and superficial infection rates in psoriatics: 5.5% and 9.1%, respectively, versus 1.2% and 7.4% in controls (62). Importantly, not all of the patients in these studies received prophylactic antibiotics.…”

Section: Limitations Of the Datamentioning

confidence: 71%

Perioperative management of tumor necrosis factor antagonists in patients with psoriasis and other inflammatory disorders

Hession

Gottlieb

2010

Journal of Dermatological Treatment

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Tumor necrosis factor alpha (TNF-α) plays an important role in host defense and possibly wound healing. It is also linked to the pathophysiology of many inflammatory diseases, including psoriasis. The TNF antagonists are a class of agents that have proven effective in treating psoriasis and psoriatic arthritis, yet the immunosuppressive effects of these agents raise concern over their use perioperatively. Currently, there is no consensus as to when TNF antagonists should be discontinued prior to surgery. Furthermore, data on the topic are limited to inflammatory bowel disease (IBD) and rheumatoid arthritis (RA). This paper reviews the literature on post-surgical outcomes in patients with RA and IBD receiving anti-TNF therapy. Although most studies reveal no statistically significant increased risk of post-surgical complications in these patients, the retrospective design and small sample size of these studies limits interpretation. Furthermore, when applying these data to psoriasis and psoriatic arthritis, physicians must also consider disease severity, individual comorbidities, and the pharmacokinetics of the different TNF antagonists. Additional studies are needed in psoriasis and psoriatic arthritis in order to develop truly evidence-based dermatologic guidelines for perioperative management of the TNF antagonists.

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Charnley Low-friction Arthroplasty in Patients with Psoriasis

Cited by 33 publications

References 0 publications

National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review

Perioperative management of tumor necrosis factor antagonists in patients with psoriasis and other inflammatory disorders

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