ACR, AAHKS release new guideline to reduce joint infections
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According to a new guideline released by the American College of Rheumatology (ACR) and American Association of Hip and Knee Surgeons (AAHKS), the risk of joint infection resulting from total hip and knee replacements can be reduced with careful management of anti-rheumatic medications during the perioperative process. The guideline represents the first time rheumatologists and orthopedic surgeons have collaborated to develop recommendations.The guideline includes eight recommendations regarding when to continue, withhold and re-start medications commonly used to treat inflammatory rheumatic diseases (e.g., rheumatoid arthritis, spondyloarthritis and systemic lupus erythematosus), as well as the optimal perioperative dosing of glucocorticoids. Key recommendations for reducing the risk of infection include:
Discontinuing biologic therapy prior to surgery in patients with inflammatory arthritis. Withholding tofacitinib for at least seven days prior to surgery in rheumatoid arthritis, spondyloarthritis and juvenile idiopathic arthritis patients. Withholding rituximab and belimumab prior to surgery in all systemic lupus erythematosus patients undergoing arthroplasty...

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