Relationship Between Total Knee Replacement and Rheumatoid Vasculitis Flare

Perioperative Medication Management and Flare Risk

• The American College of Rheumatology recommends withholding biologic agents prior to TKR surgery and planning the procedure at the end of the dosing cycle for that specific medication 1
• Continuing the current daily dose of glucocorticoids is recommended for patients with RA undergoing TKR, as per the American College of Rheumatology guidelines 2, 3

Management Considerations

• The American College of Rheumatology suggests continuing non-biologic DMARDs through the perioperative period to reduce flare risk 1
• Resume biologic agents once wound healing is evident, all sutures/staples are out, and there's no evidence of infection, as recommended by the American College of Rheumatology 4
• Monitor closely for signs of both surgical site infection and rheumatic disease flare in the postoperative period, according to the American College of Rheumatology guidelines 3