Optimización preoperatoria del paciente para una artroplastia de cadera o rodilla: parte 2
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Publicado:
oct 17, 2024
Palabras clave:
Optimización, artroplastias de cadera y rodilla, factores de riesgo
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Resumen
Las artroplastias de cadera y rodilla son procedimientos eficaces para el tratamiento de la enfermedad articular degenerativa cuando el abordaje conservador ha fracasado. El propósito de este artículo es continuar analizando los factores de riesgo modificables en un paciente antes de la cirugía, con el objetivo de disminuir las complicaciones posquirúrgicas. Estos factores incluyen obesidad, malnutrición, tabaquismo, diabetes, anemia, consumo de opiOKoides, deficiencia de vitamina D, insuficiencia renal crónica, colonización por S. aureus resistente a la meticilina y artropatías inflamatorias. Si los cirujanos conseguimos mejoras o contrarrestar estos factores podremos reducir el riesgo de complicaciones.
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Camacho Terceros, L. A., Garbini, M. F., Tillet, F., Bochatey, E., Martínez, W. F., & Lopreite, F. A. (2024). Optimización preoperatoria del paciente para una artroplastia de cadera o rodilla: parte 2. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 89(5), 544-552. https://doi.org/10.15417/issn.1852-7434.2024.89.5.1850
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Derechos de autor 2024 Revista de la Asociación Argentina de Ortopedia y Traumatología
La aceptación del manuscrito por parte de la revista implica la no presentación simultánea a otras revistas u órganos editoriales. La RAAOT se encuentra bajo la licencia Creative Commons 4.0. Atribución-NoComercial-CompartirIgual (http://creativecommons.org/licenses/by-nc-sa/4.0/deed.es). Se puede compartir, copiar, distribuir, alterar, transformar, generar una obra derivada, ejecutar y comunicar públicamente la obra, siempre que: a) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); b) no se usen para fines comerciales; c) se mantengan los mismos términos de la licencia.
En caso de que el manuscrito sea aprobado para su próxima publicación, los autores conservan los derechos de autor y cederán a la revista los derechos de la publicación, edición, reproducción, distribución, exhibición y comunicación a nivel nacional e internacional en las diferentes bases de datos, repositorios y portales.
Se deja constancia que el referido artículo es inédito y que no está en espera de impresión en alguna otra publicación nacional o extranjera.
Por la presente, acepta/n las modificaciones que sean necesarias, sugeridas en la revisión por los pares (referato), para adaptar el trabajo al estilo y modalidad de publicación de la Revista.
Citas
1. Healy WL, Iorio R, Clair AJ, Pellegrini VD, Della Valle CJ, Berend KR. Complications of total hip arthroplasty:
Standardized list, definitions, and stratification developed by The Hip Society. Clin Orthop Relat Res 2016;474(2):357-64. https://doi.org/10.1007/s11999-015-4341-7
2. Bonasia DE, Palazzolo A, Cottino U, Saccia F, Mazzola C, Rosso F, et al. Modifiable and nonmodifiable predictive
factors associated with the outcomes of total knee arthroplasty. Joints 2019;7(1):13-8. https://doi.org/10.1055/s-0039-1678563
3. Judge A, Arden NK, Cooper C, Kassim Javaid M, Carr AJ, Field RE, et al. Predictors of outcomes of total knee
replacement surgery. Rheumatology (Oxford) 2012;51(10):1804-13. https://doi.org/10.1093/rheumatology/kes075
4. Kee JR, Mears SC, Edwards PK, Barnes CL. Modifiable risk factors are common in early revision hip and knee
arthroplasty. J Arthroplasty 2017;32(12):3689-92. https://doi.org/10.1016/j.arth.2017.07.005
5. Pérez Alamino L, Tillet F, Bochatey E, Lopreite F. Optimización preoperatoria del paciente antes de una artroplastia de cadera o rodilla: parte 1. Rev Asoc Argent Ortop Traumatol 2022;87(5):721-7.
https://doi.org/10.15417/issn.1852-7434.2022.87.5.1658
6. Center for Disease Control and Prevention. https://wonder-cdc-gov
7. Rozell JC, Courtney PM, Dattilo JR, Wu CH, Lee GC. Preoperative opiate use independently predicts narcotic
consumption and complications after total joint arthroplasty. J Arthroplasty 2017;32(9):2658-62.
https://doi.org/10.1016/j.arth.2017.04.002
8. Zywiel MG, Stroh DA, Lee SY, Bonutti PM, Mont MA. Chronic opioid use prior to total knee arthroplasty. J Bone
Joint Surg Am 2011;93(21):1988-93. https://doi.org/10.2106/JBJS.J.01473
9. Goesling J, Moser SE, Zaidi B, Hassett AL, Hilliard P, Hallstrom B, et al. Trends and predictors of opioid use after
total knee and total hip arthroplasty. Pain 2016;157(6):1259-65. https://doi.org/10.1097/j.pain.0000000000000516
10. Hannon CP, Fillingham YA, Nam D, Courtney PM, Curtin BM, Vigdorchik JM, et al. Anesthesia & Analgesia
Clinical Practice Guideline Workgroup. Opioids in Total Joint Arthroplasty: The Clinical Practice Guidelines of the
American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine,
American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. J Arthroplasty 2020;35(10):2709-14.
https://doi.org/10.1016/j.arth.2020.05.034
11. Wacker M, Holick MF. Vitamin D - effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 2013;5(1):111-48. https://doi.org/10.3390/nu5010111
12. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al.; Endocrine Society.
Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J
Clin Endocrinol Metab 2011;96(7):1911-30. https://doi.org/10.1210/jc.2011-0385. Erratum in: J Clin Endocrinol
Metab 2011;96(12):3908. PMID: 21646368
13. Morrison RJM, Bunn D, Gray WK, Baker PN, White C, Rangan A, et al. VASO (Vitamin D and Arthroplasty
Surgery Outcomes) study - supplementation of vitamin D deficiency to improve outcomes after total hip or knee
replacement: study protocol for a randomised controlled feasibility trial. Trials 2017;18(1):514.
https://doi.org/10.1186/s13063-017-2255-2
14. Sigurdardottir M, Sigurdsson MI, Olafsson Y, Sverrisdottir SH, Gunnarsdottir I, Sigurdsson EL, et al. Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections. Acta Orthop 2023;94:38-44. https://doi.org/10.2340/17453674.2023.8480
15. Brambilla L, Peretti GM, Sirtori P, Maffulli N, Mangiavini L. Outcome of total hip and total knee arthroplasty and vitamin D homeostasis. Br Med Bull 2020;135(1):50-61. https://doi.org/10.1093/bmb/ldaa018
16. Weintraub MT, Guntin J, Yang J, DeBenedetti A, Karas V, Della Valle CJ, et al. Vitamin D3 supplementation prior to total knee arthroplasty: A randomized controlled trial. J Arthroplasty 2023;38(6S):S114-S119.
https://doi.org/10.1016/j.arth.2022.08.020
17. Mouli VH, Schudrowitz N, Carrera CX, Uzosike AC, Fitz W, Rajaee SS. High-dose vitamin D supplementation can
correct hypovitaminosis D prior to total knee arthroplasty. J Arthroplasty 2022;37(2):274-8.
https://doi.org/10.1016/j.arth.2021.10.016
18. Morrison RJM, Fishley WG, Rankin KS, Reed MR. The effect of vitamin D supplementation on outcomes
following total hip or knee arthroplasty surgery: a rapid systematic review of current evidence. EFORT Open Rev
2022;7(5):305-11. https://doi.org/10.1530/EOR-21-0136
19. Levey AS, Inker LA. Definition and staging of chronic kidney disease in adults. UpToDate. Disponible en:
https://www.uptodate.com/contents/definition-and-staging-of-chronic-kidney-disease-in-adults?search=chronic%20 reanl%20diseasse&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3
20. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al. CKD-EPI (Chronic Kidney
Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med
2009;150:604-12. https://doi.org/10.7326/0003-4819-150-9-200905050-00006
21. Jämsä PP, Oksala NKJ, Eskelinen AP, Jämsen ER. Chronic kidney diseases among patients undergoing elective
arthroplasty: risk groups and the value of serum creatinine. J Arthroplasty 2018;33(1):230-4.e1.
https://doi.org/10.1016/j.arth.2017.07.050
22. Jämsä P, Jämsen E, Huhtala H, Eskelinen A, Oksala N. Moderate to severe renal insufficiency is associated with
high mortality after hip and knee replacement. Clin Orthop Relat Res 2018;476(6):1284-92. https://doi.org/10.1007/s11999.0000000000000256
23. Fox JA, Dominguez GA, DeMaio CV, Brockman BS, Malloy K, Thakral R. Total hip arthroplasty complications
in patients with chronic kidney disease: A comparison study. J Orthop 2023;39:1-6. https://doi.org/10.1016/j.jor.2023.03.013
24. Jämsä P, Reito A, Oksala N, Eskelinen A, Jämsen E. Does chronic kidney disease affect implant survival after
primary hip and knee arthroplasty? Bone Joint J 2021;103-B(4):689-95. https://doi.org/10.1302/0301-620X.103B4.BJJ-2020-0715.R2
25. Lee SH, Lin YC, Chang CJ, Fan Chiang CY, Chen SY, Chang YH, et al. Outcome and cost analysis of primary
total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study. Biomed J
2021;44(5):620-6. https://doi.org/10.1016/j.bj.2020.04.010
26. Schweizer ML, Chiang HY, Septimus E, Moody J, Braun B, Hafner J, et al. Association of a bundled intervention
with surgical site infections among patients undergoing cardiac, hip, or knee surgery. JAMA 2015;313:2162-2171.
https://doi.org/10.1001/jama.2015.5387
27. Sousa RJ, Barreira PM, Leite PT, Santos AC, Ramos MH, Oliveira AF. Preoperative Staphylococcus aureus
screening/decolonization protocol before total joint arthroplasty-Results of a small prospective randomized trial. J Arthroplasty 2016;31(1):234-9. https://doi.org/10.1016/j.arth.2015.08.003
28. Ashkenazi I, Thomas J, Lawrence KW, Rozell JC, Lajam CM, Schwarzkopf R. Positive preoperative colonization
with methicillin resistant Staphylococcus aureus is associated with inferior postoperative outcomes in patients
undergoing total joint arthroplasty. J Arthroplasty 2023;38(6):1016-23. https://doi.org/10.1016/j.arth.2023.02.065
29. Santana DC, Klika AK, Jin Y, Emara AK, Piuzzi NS; Cleveland Clinic Orthopaedic Minimal Dataset Episode of
Care (OME) Arthroplasty Group. Preoperative colonization with Staphylococcus aureus in THA is associated with
increased length of stay. Clin Orthop Relat Res 2022;480(8):1504-14. https://doi.org/10.1097/CORR.0000000000002136
30. Uçkay I, Lübbeke A, Harbarth S, Emonet S, Tovmirzaeva L, Agostinho A, et al. Low risk despite high endemicity
of methicillin–resistant staphylococcus aureus infections following elective total joint arthroplasty: a 12-year
experience. Ann Med 2012;44:360-8. https://doi.org/10.3109/07853890.2010.550932
31. Tsang ST, McHugh MP, Guerendiain D, Gwynne PJ, Boyd J, Simpson AH, et al. Underestimation of staphylococcus aureus (MRSA and MSSA) carriage associated with standard culturing techniques: one third of carriers missed. Bone Joint Res 2018;7:79-84. https://doi.org/10.1302/2046–3758.71.BJR–2017–0175.R1
32. Ammerlaan HS, Kluytmans JA, Wertheim HF, Nouwen JL, Bonten MJ. Eradication of methicillin–resistant
staphylococcus aureus carriage: a systematic review. Clin Infect Dis 2009;48:922-30. https://doi.org/10.1086/597291
33. Steed LL, Costello J, Lohia S, Jones T, Spannhake EW, Nguyen S. Reduction of nasal staphylococcus aureus
carriage in health care professionals by treatment with a nonantibiotic, alcohol–based nasal antiseptic. Am J Infect Control 2014;42:841-6. https://doi.org/10.1016/j.ajic.2014.04.008
34. Anderson MJ, David ML, Scholz M, Bull SJ, Morse D, Hulse-Stevens M, et al. Efficacy of skin and nasal
povidone–iodine preparation against mupirocin–resistant methicillin–resistant staphylococcus aureus and S. aureus within the anterior nares. Antimicrob Agents Chemother 2015;59:27652773. https://doi.org/10.1128/AAC.04624–14
35. Goodman SM, Bass AR. Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review. BMC Rheumatol 2018;2:2. https://doi.org/10.1186/s41927-018-0008-9
36. Cordtz R, Odgaard A, Kristensen LE, Overgaard S, Dreyer L. Risk of medical complications following total hip or knee arthroplasty in patients with rheumatoid arthritis: A register-based cohort study from Denmark, Semin Arthritis Rheum 2020;50(1):30-5. https://doi.org/10.1016/j.semarthrit.2019.06.007
37. Galloway JB, Hyrich KL, Mercer LK, Dixon WG, Fu B, Ustianowski AP, et al. Anti-TNF therapy is associated
with an increased risk of serious infections in patients with rheumatoid arthritis especially in the first 6 months of
treatment: updated results from the British Society for Rheumatology Biologics Register with special emphasis
on risks in the elderly. Rheumatology (Oxford) 2011;50(1):124-31. https://doi.org/10.1093/rheumatology/keq242
38. Goodman SM, Springer BD, Chen AF, Davis M, Fernandez DR, Figgie M, et al. American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management
of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee
Arthroplasty. Arthritis Care Res (Hoboken) 2022;74(9):1399-1408. https://doi.org/10.1002/acr.24893 3
Standardized list, definitions, and stratification developed by The Hip Society. Clin Orthop Relat Res 2016;474(2):357-64. https://doi.org/10.1007/s11999-015-4341-7
2. Bonasia DE, Palazzolo A, Cottino U, Saccia F, Mazzola C, Rosso F, et al. Modifiable and nonmodifiable predictive
factors associated with the outcomes of total knee arthroplasty. Joints 2019;7(1):13-8. https://doi.org/10.1055/s-0039-1678563
3. Judge A, Arden NK, Cooper C, Kassim Javaid M, Carr AJ, Field RE, et al. Predictors of outcomes of total knee
replacement surgery. Rheumatology (Oxford) 2012;51(10):1804-13. https://doi.org/10.1093/rheumatology/kes075
4. Kee JR, Mears SC, Edwards PK, Barnes CL. Modifiable risk factors are common in early revision hip and knee
arthroplasty. J Arthroplasty 2017;32(12):3689-92. https://doi.org/10.1016/j.arth.2017.07.005
5. Pérez Alamino L, Tillet F, Bochatey E, Lopreite F. Optimización preoperatoria del paciente antes de una artroplastia de cadera o rodilla: parte 1. Rev Asoc Argent Ortop Traumatol 2022;87(5):721-7.
https://doi.org/10.15417/issn.1852-7434.2022.87.5.1658
6. Center for Disease Control and Prevention. https://wonder-cdc-gov
7. Rozell JC, Courtney PM, Dattilo JR, Wu CH, Lee GC. Preoperative opiate use independently predicts narcotic
consumption and complications after total joint arthroplasty. J Arthroplasty 2017;32(9):2658-62.
https://doi.org/10.1016/j.arth.2017.04.002
8. Zywiel MG, Stroh DA, Lee SY, Bonutti PM, Mont MA. Chronic opioid use prior to total knee arthroplasty. J Bone
Joint Surg Am 2011;93(21):1988-93. https://doi.org/10.2106/JBJS.J.01473
9. Goesling J, Moser SE, Zaidi B, Hassett AL, Hilliard P, Hallstrom B, et al. Trends and predictors of opioid use after
total knee and total hip arthroplasty. Pain 2016;157(6):1259-65. https://doi.org/10.1097/j.pain.0000000000000516
10. Hannon CP, Fillingham YA, Nam D, Courtney PM, Curtin BM, Vigdorchik JM, et al. Anesthesia & Analgesia
Clinical Practice Guideline Workgroup. Opioids in Total Joint Arthroplasty: The Clinical Practice Guidelines of the
American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine,
American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. J Arthroplasty 2020;35(10):2709-14.
https://doi.org/10.1016/j.arth.2020.05.034
11. Wacker M, Holick MF. Vitamin D - effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 2013;5(1):111-48. https://doi.org/10.3390/nu5010111
12. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al.; Endocrine Society.
Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J
Clin Endocrinol Metab 2011;96(7):1911-30. https://doi.org/10.1210/jc.2011-0385. Erratum in: J Clin Endocrinol
Metab 2011;96(12):3908. PMID: 21646368
13. Morrison RJM, Bunn D, Gray WK, Baker PN, White C, Rangan A, et al. VASO (Vitamin D and Arthroplasty
Surgery Outcomes) study - supplementation of vitamin D deficiency to improve outcomes after total hip or knee
replacement: study protocol for a randomised controlled feasibility trial. Trials 2017;18(1):514.
https://doi.org/10.1186/s13063-017-2255-2
14. Sigurdardottir M, Sigurdsson MI, Olafsson Y, Sverrisdottir SH, Gunnarsdottir I, Sigurdsson EL, et al. Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections. Acta Orthop 2023;94:38-44. https://doi.org/10.2340/17453674.2023.8480
15. Brambilla L, Peretti GM, Sirtori P, Maffulli N, Mangiavini L. Outcome of total hip and total knee arthroplasty and vitamin D homeostasis. Br Med Bull 2020;135(1):50-61. https://doi.org/10.1093/bmb/ldaa018
16. Weintraub MT, Guntin J, Yang J, DeBenedetti A, Karas V, Della Valle CJ, et al. Vitamin D3 supplementation prior to total knee arthroplasty: A randomized controlled trial. J Arthroplasty 2023;38(6S):S114-S119.
https://doi.org/10.1016/j.arth.2022.08.020
17. Mouli VH, Schudrowitz N, Carrera CX, Uzosike AC, Fitz W, Rajaee SS. High-dose vitamin D supplementation can
correct hypovitaminosis D prior to total knee arthroplasty. J Arthroplasty 2022;37(2):274-8.
https://doi.org/10.1016/j.arth.2021.10.016
18. Morrison RJM, Fishley WG, Rankin KS, Reed MR. The effect of vitamin D supplementation on outcomes
following total hip or knee arthroplasty surgery: a rapid systematic review of current evidence. EFORT Open Rev
2022;7(5):305-11. https://doi.org/10.1530/EOR-21-0136
19. Levey AS, Inker LA. Definition and staging of chronic kidney disease in adults. UpToDate. Disponible en:
https://www.uptodate.com/contents/definition-and-staging-of-chronic-kidney-disease-in-adults?search=chronic%20 reanl%20diseasse&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3
20. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al. CKD-EPI (Chronic Kidney
Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med
2009;150:604-12. https://doi.org/10.7326/0003-4819-150-9-200905050-00006
21. Jämsä PP, Oksala NKJ, Eskelinen AP, Jämsen ER. Chronic kidney diseases among patients undergoing elective
arthroplasty: risk groups and the value of serum creatinine. J Arthroplasty 2018;33(1):230-4.e1.
https://doi.org/10.1016/j.arth.2017.07.050
22. Jämsä P, Jämsen E, Huhtala H, Eskelinen A, Oksala N. Moderate to severe renal insufficiency is associated with
high mortality after hip and knee replacement. Clin Orthop Relat Res 2018;476(6):1284-92. https://doi.org/10.1007/s11999.0000000000000256
23. Fox JA, Dominguez GA, DeMaio CV, Brockman BS, Malloy K, Thakral R. Total hip arthroplasty complications
in patients with chronic kidney disease: A comparison study. J Orthop 2023;39:1-6. https://doi.org/10.1016/j.jor.2023.03.013
24. Jämsä P, Reito A, Oksala N, Eskelinen A, Jämsen E. Does chronic kidney disease affect implant survival after
primary hip and knee arthroplasty? Bone Joint J 2021;103-B(4):689-95. https://doi.org/10.1302/0301-620X.103B4.BJJ-2020-0715.R2
25. Lee SH, Lin YC, Chang CJ, Fan Chiang CY, Chen SY, Chang YH, et al. Outcome and cost analysis of primary
total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study. Biomed J
2021;44(5):620-6. https://doi.org/10.1016/j.bj.2020.04.010
26. Schweizer ML, Chiang HY, Septimus E, Moody J, Braun B, Hafner J, et al. Association of a bundled intervention
with surgical site infections among patients undergoing cardiac, hip, or knee surgery. JAMA 2015;313:2162-2171.
https://doi.org/10.1001/jama.2015.5387
27. Sousa RJ, Barreira PM, Leite PT, Santos AC, Ramos MH, Oliveira AF. Preoperative Staphylococcus aureus
screening/decolonization protocol before total joint arthroplasty-Results of a small prospective randomized trial. J Arthroplasty 2016;31(1):234-9. https://doi.org/10.1016/j.arth.2015.08.003
28. Ashkenazi I, Thomas J, Lawrence KW, Rozell JC, Lajam CM, Schwarzkopf R. Positive preoperative colonization
with methicillin resistant Staphylococcus aureus is associated with inferior postoperative outcomes in patients
undergoing total joint arthroplasty. J Arthroplasty 2023;38(6):1016-23. https://doi.org/10.1016/j.arth.2023.02.065
29. Santana DC, Klika AK, Jin Y, Emara AK, Piuzzi NS; Cleveland Clinic Orthopaedic Minimal Dataset Episode of
Care (OME) Arthroplasty Group. Preoperative colonization with Staphylococcus aureus in THA is associated with
increased length of stay. Clin Orthop Relat Res 2022;480(8):1504-14. https://doi.org/10.1097/CORR.0000000000002136
30. Uçkay I, Lübbeke A, Harbarth S, Emonet S, Tovmirzaeva L, Agostinho A, et al. Low risk despite high endemicity
of methicillin–resistant staphylococcus aureus infections following elective total joint arthroplasty: a 12-year
experience. Ann Med 2012;44:360-8. https://doi.org/10.3109/07853890.2010.550932
31. Tsang ST, McHugh MP, Guerendiain D, Gwynne PJ, Boyd J, Simpson AH, et al. Underestimation of staphylococcus aureus (MRSA and MSSA) carriage associated with standard culturing techniques: one third of carriers missed. Bone Joint Res 2018;7:79-84. https://doi.org/10.1302/2046–3758.71.BJR–2017–0175.R1
32. Ammerlaan HS, Kluytmans JA, Wertheim HF, Nouwen JL, Bonten MJ. Eradication of methicillin–resistant
staphylococcus aureus carriage: a systematic review. Clin Infect Dis 2009;48:922-30. https://doi.org/10.1086/597291
33. Steed LL, Costello J, Lohia S, Jones T, Spannhake EW, Nguyen S. Reduction of nasal staphylococcus aureus
carriage in health care professionals by treatment with a nonantibiotic, alcohol–based nasal antiseptic. Am J Infect Control 2014;42:841-6. https://doi.org/10.1016/j.ajic.2014.04.008
34. Anderson MJ, David ML, Scholz M, Bull SJ, Morse D, Hulse-Stevens M, et al. Efficacy of skin and nasal
povidone–iodine preparation against mupirocin–resistant methicillin–resistant staphylococcus aureus and S. aureus within the anterior nares. Antimicrob Agents Chemother 2015;59:27652773. https://doi.org/10.1128/AAC.04624–14
35. Goodman SM, Bass AR. Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review. BMC Rheumatol 2018;2:2. https://doi.org/10.1186/s41927-018-0008-9
36. Cordtz R, Odgaard A, Kristensen LE, Overgaard S, Dreyer L. Risk of medical complications following total hip or knee arthroplasty in patients with rheumatoid arthritis: A register-based cohort study from Denmark, Semin Arthritis Rheum 2020;50(1):30-5. https://doi.org/10.1016/j.semarthrit.2019.06.007
37. Galloway JB, Hyrich KL, Mercer LK, Dixon WG, Fu B, Ustianowski AP, et al. Anti-TNF therapy is associated
with an increased risk of serious infections in patients with rheumatoid arthritis especially in the first 6 months of
treatment: updated results from the British Society for Rheumatology Biologics Register with special emphasis
on risks in the elderly. Rheumatology (Oxford) 2011;50(1):124-31. https://doi.org/10.1093/rheumatology/keq242
38. Goodman SM, Springer BD, Chen AF, Davis M, Fernandez DR, Figgie M, et al. American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management
of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee
Arthroplasty. Arthritis Care Res (Hoboken) 2022;74(9):1399-1408. https://doi.org/10.1002/acr.24893 3