Systemic Lupus Erythematosus Does Not Increase Risk of Adverse Events in the First 6 Months After Total Knee Arthroplasty

Fein, Arielle W.; Figgie, Caroline A.; Dodds, Taylor R.; Wright-Chisem, Joshua; Parks, Michael L.; Mandl, Lisa A.; Su, Edwin P.; Salmon, Jane E.; Mayman, David J.; Lee, Yuo-yu; Figgie, Mark P.; Goodman, Susan M.

doi:10.1097/rhu.0000000000000435

Cited by 20 publications

(11 citation statements)

References 14 publications

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“…According to Abu-Shakra et al [ 27 ], patients with systemic lupus erythematosus have an increased risk of osteonecrosis. On the contrary, Fein et al [ 28 ], Roberts et al [ 24 ] determined ON and adverse events were not related to steroid use.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis comparing complications following total hip arthroplasty for systemic lupus erythematosus versus for non-systemic lupus erythematosus

Huang

Guan

et al. 2022

J Orthop Surg Res

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Background Osteonecrosis of the femoral head is one of the most severe complications in systemic lupus erythematosus (SLE) patients. Total hip arthroplasty (THA) is an effective treatment for femoral head necrosis. However, there is no consensus on the specific effect of THA on SLE patients. The objective of the present study was to review the current evidence regarding rates of THA complications and postoperative function in systemic lupus erythematosus. Methods Two independent reviewers searched PubMed, Cochrane Library, and EMBASE from January 1, 2000, to December 29, 2021. The primary outcomes were postoperative complications, including deep vein thrombosis (DVT), hematoma, wound infection, dislocation, periprosthetic fracture, revision, mortality. Results A total of 179 articles yielded 28 studies eligible for inclusion with 10 studies used for meta-analysis. This study found a statistically significant difference in DVT, dislocation, wound infection, periprosthetic fracture, and revision. Conclusions This meta-analysis shows that SLE patients with THA are at an increased risk of DVT, wound infection, dislocation, periprosthetic fracture, revision, periprosthetic joint infection, following THA in comparison with non-SLE patients with THA. There was no adequate evidence to support the notion that the risk of seroma or hematoma following THA is increased in SLE. Also, there was no significant difference in HHS scores between SLE patients and non-SLE patients after THA.

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Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis comparing complications following total hip arthroplasty for systemic lupus erythematosus versus for non-systemic lupus erythematosus

Huang

Guan

et al. 2022

J Orthop Surg Res

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“…The usefulness of a preoperative corticosteroid stress-dose has long been debated. Although there is no evidence of an increased risk of adverse events in patients taking a perioperative stress-dose compared with the usual dose of corticosteroids [ 77 ], there is no proof-of-concept that a routine administration of a stress-dose may reduce the risk of haemodynamic instability in adult patients with IRD undergoing major orthopaedic surgery receiving ≤ 16 mg/day prednisone or equivalent [ 70 , 78 ].…”

Section: Methodsmentioning

confidence: 99%

Perioperative Management of Patients with Inflammatory Rheumatic Diseases Undergoing Major Orthopaedic Surgery: A Practical Overview

2018

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Patients with inflammatory rheumatic diseases often need orthopaedic surgery due to joint involvement. Total hip replacement and total knee replacement are frequent surgical procedures in these patients. Due to the complexity of the inflammatory rheumatic diseases, the perioperative management of these patients must envisage a multidisciplinary approach. The frequent association with extraarticular comorbidities must be considered when evaluating perioperative risk of the patient and should guide the clinician in the decision-making process. However, guidelines of different medical societies may vary and are sometimes contradictory. Orthopaedics should collaborate with rheumatologists, anaesthesiologists and, when needed, cardiologists and haematologists with the common aim of minimising perioperative risk in patients with inflammatory rheumatic diseases. The aim of this review is to provide the reader with simple practical recommendations regarding perioperative management of drugs such as disease-modifying anti-rheumatic drugs, corticosteroids, non-steroidal anti-inflammatory drugs and tools for a risk stratification for cardiovascular and thromboembolic risk based on current evidence for patients with inflammatory rheumatic diseases.

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“…Indispensability of the GC preoperative dose has long been under discussion. As of today, there is no evidence of an elevated risk of side effects, requiring a stress dose, instead of a regular one [55]. However, there are no facts supporting the concept of an elevated GC dose possibly reducing the hemodynamic instability of the RA patients after a major orthopedic intervention in comparison to the patients receiving a regular daily Prednisone dose of ≤ 15 mg [56].…”

Section: Glucocorticoid (Gc) Usementioning

confidence: 99%

Менеджмент Пацієнтів З Ревматоїдним Артритом У Періопераційному Періоді

Syniachenko¹,

Golovach²,

Yehudіna³

2021

PJS

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Despite the rapid development of biological therapy and decisive establishment of such medication in the rheumatic disease management, rheumatoid arthritis (RA) patients are often subjected to orthopedic surgical interventions [1]. Joint endoprosthetics, arthroplasty, arthroscopic debridement, tendon reconstruction, rheumatoid nodule removal, tunnel and wrist canal decompression-all of these procedures , and numerous others, make up a list of orthopedic interventions indicated to treat rheumatoid arthritis. Furthermore, the RA patients undergo surgery due to their somatic conditions much more often than the rest of the population [1]. Perioperative period involves a number of infection-related risks, such as surgical wound infection and pneumonia. Arthroplasty and other interventions involving prosthet

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Systemic Lupus Erythematosus Does Not Increase Risk of Adverse Events in the First 6 Months After Total Knee Arthroplasty

Abstract: SLE is not an independent risk factor for increased AEs 6 months after TKA. Stress-dose steroid use does not heighten AE risk. These findings should inform recommendations for SLE patients considering TKA.

Cited by 20 publications

References 14 publications

A systematic review and meta-analysis comparing complications following total hip arthroplasty for systemic lupus erythematosus versus for non-systemic lupus erythematosus

A systematic review and meta-analysis comparing complications following total hip arthroplasty for systemic lupus erythematosus versus for non-systemic lupus erythematosus

Perioperative Management of Patients with Inflammatory Rheumatic Diseases Undergoing Major Orthopaedic Surgery: A Practical Overview

Менеджмент Пацієнтів З Ревматоїдним Артритом У Періопераційному Періоді

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