Post- operative complications for patients with Rheumatoid arthritis undergoing elective orthopedic procedures with or without methotrexate

Abstract

Background: Rheumatoid arthritis (RA) is a common and disabling condition that is now often treated by the cytotoxic drug methotrexate. The present study was conducted to assess post- operative complications for patients with Rheumatoid arthritis undergoing elective orthopedic procedures with or without methotrexate. Materials & Methods: 60 patients diagnosed with Rheumatoid arthritis were divided into 2 groups of 30 each. Group I patients with RA who were receiving methotrexate for at least six weeks before surgery and in whom methotrexate treatment was not discontinued. Group II patients with RA who were receiving methotrexate for type of surgery and in whom methotrexate treatment was stopped two weeks before surgery and restarted two weeks after surgery. Group III patients with RA who underwent elective orthopaedic surgery during the study period and who had not received methotrexate treatment. Complications were recorded. Results: Group I had 11 males and 9 females, group II had 10 males and 10 females and group III had 8 males and 12 females. Mean age was 54.2 years, 56.7 years and 54.6 years respectively, disease duration was 18.2 years, 19.1 years and 19.8 years respectively, baseline articular index was 14.1 years, 16 years and 15.7 years respectively and HAQ was 1.8, 1.8 and 1.7 years respectively. The most common complication was dehiscence seen 7 in group III, 3 in group II and 1 in group I followed by discharge seen 7 in group III, 2 in group II and 1 in group I. The difference was significant (P< 0.05). Conclusion: Continuation of methotrexate treatment does not increase the risk of either infections or of surgical complications occurring in patients with RA.