Diseases of the connective tissue are a varied group of disorders with major musculoskeletal manifestations such as joint pain and loss of function. As a consequence of the accompanying inflammatory joint disease, such patients often require surgery. Due to the protean organ-related consequences of these conditions, patients who suffer from chronic connective tissue disease are a highly challenging population in the perioperative context. This paper reviews the management of such patients in this clinical setting.
Osnes-RingenHKvienTKHenriksenJEOrthopedic surgery in 255 patients with inflammatory arthropathies: longitudinal effects on pain, physical function and health-related quality of lifeAnn Rheum Dis2009681596–160110.1136/ard.2008.096362
2.
JamsenEHuhtalaHHHoilanenTRisk factors of infection after knee arthroplasty. A register-base analysis of 43,149 casesJ Bone Jt Surg Am200991138–4710.2106/JBJS.G.01686
3.
BongartzTHalliganCSOsmonDRIncidence and risk factors of prosthetic joint infectin after total hip or knee replacement in patients with rheumatoid arthritisArthritis Rheum200859121713–2010.1002/art.24060
4.
ErkanDLeibowitzEBermanJPerioperative medical management of antiphosholipid syndrome: hospital for special surgery experience, review of literature, and recommendationsJ Rheum2002294843–849
5.
ScanzelloCFNestorBJPerioperative management of medications used in the treatment of rheumatoid arthritisHSS Journ20062141–14710.1007/s11420-006-9012-5
6.
MacKenzieCRPerioperative management of rheumatoid arthritis in patients on biologicsCont Topics in RA2008242–5
7.
RomanMHSalmonJCardiovascular manifestations of rheumatologic diseaseCirc20071162346–235510.1161/CIRCULATIONAHA.106.678334
8.
UrowitzMBBookmanAAKoehlessBEThe bimodal mortality pattern of SLEAm J Med197660221–510.1016/0002-9343(76)90431-9
9.
ManziSMeilahnENRaurieJEAge specific incidence rate of MI and angina in woman with SLE: comparison with the Framingham studyAm J Epi1997145408–415
10.
CoblynJO'GaraPTHochbergMCSilmanAJSmolenJSWeinblattMEWeismanMHThe heart in rheumatic diseaseRheumatology20033TorontoMosby Elsevier
11.
FleisherLABeckmanJABrownKAACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice GuidelinesJ Am Coll Cardiol200750159–24210.1016/j.jacc.2007.09.003
12.
KwonEFleisherLAEagleKNewmanMFFleisherLAFinkMPCardiac risk assessment in noncardiac surgeryPerioperative medicine: managing for outcome2008PhiladelphiaSanders Elsevier
13.
HalmWBrownerWSTubauJFEchocardiography for assessing cardiac risk in patients having noncardiac surgery. Study of Perioperative Ischemia Research GroupAnn Int Med1996125433–441
14.
ManganoDTLayugBTateoIEffect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research GroupN Eng J Med19963351713–172010.1056/NEJM199612053352301
15.
DevereauxPJYangHYusufSPOISE Study Group. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomized controlled trialLancet20083711839–184710.1016/S0140-6736(08)60601-7
16.
BennetSJBerryOMGoddardJAcute renal dysfunction following hip fractureInjury201041335–33810.1016/j.injury.2009.07.009
17.
MarkerGABrodnerWGiureaALong-term follow-up of metal-on-metal total hip replacementJ Orthop Res2007257841–84810.1002/jor.20381
18.
SharrockNEBeksacBFlynnEHypotensive epidural anaesethesia in patients with preoperative renal dysfunction undergoing total hip replacementBr J Anaesth2006962207–21210.1093/bja/aei308
19.
GrublAMarkerWGiureaBSLong-term follow-up of metal-on-metal total hip replacementJ Orthop Res2007257841–4810.1002/jor.20381
20.
RamakrishnaGSprungJRaviBSImpact of pulmonary hypertension on the outcome of noncardiac surgery. Predictors of perioperative morbidity and mortalityJ Am Coll Card2005451691–169910.1016/j.jacc.2005.02.055
21.
McGlothlin D and T De Marco. Preoperative Risk Assessment of Pulmonary Arterial Hypertension Patients Undergoing General Surgery. Advan Pulm Hyperten 2007;6
22.
Parisi MD, Koval K, Egoi K. Fat embolism syndrome. Am J Ortho 1990;507–512.
23.
SierraRJTrousdaleRTCabanelaMEPregnancy and childbirth after total hip arthroplastyJ Bone Joint Surg200587121–4
24.
FeinbergMRCapelloWNDetterlineAJClinical outcome and incidence of pregnancy after bipolar and total hip arthroplasty in young womanJ Arthroplasty2003187879–8510.1016/S0883-5403(03)00270-5
25.
BordiniSSToniTASafetly of pregnancy and delivery after total hip arthroplastyJ Womens Health (Larchmt)20071691300–410.1089/jwh.2006.0326
26.
ZiaeeHDanielJDuttaAKTransplacental transfer of cobalt and chromium in patients with metal-on-metal hip arthroplastyJ Bone Joint Arthroplasty200789-b3301–305
27.
GrennanDMGrayJLoundonJMethotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopedic surgeryAnn Rheum Dis200160214–1710.1136/ard.60.3.214
28.
FuerstMMohlHBaumgartelLeflunomide increases the risk of early healing complications in patients with rheumatoid arthritis underoing elective orthopedic surgeryRheum Int200626121138–4210.1007/s00296-006-0138-z
29.
TanakaNSakahashiHsatoEExamination of the risk of continuous leflunomide treatment on the incidence of infectious complications after joint arthroplasty in patients with patients with rheumatoid arthritisJ Clin Rheum200392115–810.1097/01.RHU.0000062514.54375.bd
30.
BibboCGoldbergJWInfectious and healing complications after elective orthopaedic foot and ankle surgery during tumor necrosis factor-alpha inhibition therapyFoot Ankle Int2004255331–335
31.
GilesJTBartlettSJGelberACTumor necrosis factor inhibitor therapy and risk of serious postoperative orthopedic infection in rheumatoid arthritisArthritis Rheum2006552333–33510.1002/art.21841
32.
MarchalLD'HaensGvan AsscheGThe risk of post-operative complications associated with infliximab therapy for Crohn's disease: a controlled cohort studyAilment Pharmacol Ther199619749–5410.1111/j.1365-2036.2004.01904.x
33.
PhamTClaudepierrePDeprezXAnti-TNF alpha therapy and safety monitoring. Clinical tool guide elaborated by the Club Rhumatismes et Inflammations (CRI), section of the French Society of Rheumatology (SFR)Joint Bone Spine200572Suppl1–58
34.
LedinghamJDeightonCBritish Society for Rheumatology Standards, Guidelines and Audit Working Group (SGWAG) Update on the British Society for Rheumatology guidelines for prescribing TNR-alpha blockers in adults with rheumatoid arthritis (update of previous guidelines of April 2001)Rheumatol2001442157–16310.1093/rheumatology/keh464
35.
BrombergJSAlfreyEJBarkerCFAdrenal suppression and steroid supplementation in renal transplant recipientsTransplant199151123–12910.1097/00007890-199101000-00019
36.
GlowniakJVLoriauxDLA double-blind study of perioperative steroid requirements in secondary adrenal insufficiencySurgery1997121123–2910.1016/S0039-6060(97)90280-4
37.
LeopoldSSCasnellieMTWarmeWJEndogenous cortisol production in response to knee arthroscopy and total knee arthroplastyJ Bone JT Surg Am200385A2163–67
38.
Willis AA, Warren RF, Craig EV, et al. Deep-Vein Thrombosis Following Reconstructive Shoulder Arthroplasty. HSS Alumni Day Presentation 2004.
39.
WestrichGHWekslerBBGlueckCJCorrelation of thrombophilia and hypofibrinolysis with pulmonary embolism following total hip arthroplastyJ Bone Jt Surg Am2002842161–67
40.
Della ValleAGSerotaAGoGVTE is rare with a multi-modal prophylaxis protocol after THAClin Ortho Rel Research2006444146–15310.1097/01.blo.0000201157.29325.f0
