The Peri-operative Management of the Rheumatoid Patient Undergoing Total Knee Arthroplasty: A Review of Literature
Mohammad Z. Sohail,
Sammy A Hanna,
Atif A. Malik,
Wasim S. Khan.
Rheumatoid arthritis is the commonest inflammatory arthropathy, and affects synovium,
cartilage and bone. Despite recent improvements with disease modifying biological agents, progressive
joint destruction may continue eventually leading to the need for joint arthroplasty. The knee joint
is involved in 90% of patients with rheumatoid arthritis, and total knee arthroplasty is being performed
in many patients to alleviate pain and recover function. However, complications are not uncommon. In
this review of the literature we look at pre-operative, intra-operative and post-operative factor that
need to be taken into account to reduce the risk of complications in these patients. Due to the systemic
nature of rheumatoid arthritis, a multi-disciplinary approach is crucial. This includes addressing medical and pharmacological
issues, and anesthetic concerns pre-operatively, and anticipating and preventing relevant complications postoperatively.
Keywords: Complications, management, multidisciplinary approach, rheumatoid patient, total knee arthroplasty.
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