Abstract
Purpose : There is no clear standard guideline for the use of biological agents during the perioperative period. We investigated the adverse effects of a biological agent in patients who underwent orthopedic surgery for rheumatoid arthritis.
Subjects and Methods : The subjects were 5 women, with a mean age of 53 years (range : 39-66 years). Three patients had knee lesions, one had an elbow lesion, and one had a cervical spine lesion. The mean postoperative follow-up period was 19 months (range : 7-35 months). All patients had been receiving etanercept preoperatively. The adverse effects of etanercept were investigated at the start of administration, during the peri-surgical suspension period, and after re-administration postoperatively.
Results : Preoperative administration of etanercept was suspended for an average of 6 weeks (range : 2-20 weeks) and postoperative re-administration was started at an average of 9.8 weeks (range : 2-40 weeks) after surgery. Due to delayed wound healing, etanercept was readministered at 3 weeks after surgery in one patient, and at 40 weeks after surgery in another patent. All patients who were able to resume etanercept treatment did not develop joint inflammation.
Discussion : We consider that flexible decision-making is necessary when judging the timing of postoperative re-administration of etanercept in individual cases, in order to avoid recurrence of arthritis.
