PERIOPERATIVE USE OF METHOTREXATE IN PATIENTS WITH RHEUMATOID-ARTHRITIS UNDERGOING ORTHOPEDIC-SURGERY

Methotrexate (MTX) is commonly prescribed for the treatment of rheumat oid arthritis. Its use seems to be an independent risk factor for infe ction with common pathogens and opportunistic organisms. Some rheumato logists and orthopedic surgeons hold the opinion that MTX should be te mporarily withheld to lessen the likelihood of postoperative infection or poor wound healing. Alternatively, some clinicians believe that MT X should be continued throughout the perioperative period to avoid fla res in rheumatoid arthritis disease activity. There are no definitive studies on which to rely in this decision-making process, but the auth ors believe that withholding MTX for 2 weeks of the perioperative peri od is a reasonable and prudent approach.