Objective: Patients with inflammatory arthritis pose unique systemic problems because of the possibility of inflammatory involvement of many organs, especially the lungs, heart, gastrointestinal tract, and kidneys, so it is very important to recognize preperative complications, to facilitate an uncomplicated operative course.
The aim of this study was to evaluate general complications in patients who were to have total joint replacements.
Methods: 451 patients (301 patients with rheumatoid arthritis, 149 patients with osteoarthritis) who were admitted to have hip or knee arthroplasty were submitted to electrocardiogram, echocardiogram, intravenous dipyridamole stress thallium myocardial perfusion imaging, computed tomography of the upper intestinal organs and the lungs, upper gastrointestinal fiberscopy, and 75g oral glucose tolerance test.
Results: 70% of the patients had some preoperative medical problems; in particular. ischemic heart disease and impaired glucose tolerance were not recognized before this assessment. There were no significant differences between RA and OA patients in that report.
The rheumatologist must make thorough evaluations of systemic complications preoperatively in patients who are going to have total joint replacement, and interact closely with anesthesiologists and physicians to facilitate an uncomplicated operative course.
