Key Points
` Patients with rheumatic diseases undergoing total hip arthroplasty (THA)
and total knee arthroplasty (TKA) are at increased risk for periprosthetic
joint infection.
` Appropriate management of antirheumatic medication in the perioperative
period may provide an important opportunity to mitigate risk.
` Nonbiologic disease-modifying antirheumatic drugs may be continued
throughout the perioperative period in patients with rheumatic diseases
who are undergoing elective THA and TKA.
` Biologic medications should be withheld as close to 1 dosing cycle as
scheduling permits prior to elective THA and TKA and restarted after
evidence of wound healing, typically 14 days, for all patients with rheumatic
diseases.