SPECIAL ARTICLEAmerican College of Rheumatology/AmericanAssociation of Hip and Knee Surgeons Guideline for thePerioperative Management of Antirheumatic Medication inPatients With Rheumatic Diseases Undergoing ElectiveTotal Hip or Total Knee ArthroplastySusan M. Goodman,1 Bryan Springer,2 Gordon Guyatt,3 Matthew P. Abdel,4Vinod Dasa,5 Michael George,6 Ora Gewurz-Singer,7 Jon T. Giles,8 Beverly Johnson,9Steve Lee,10 Lisa A. Mandl,1 Michael A. Mont,11 Peter Sculco,1 Scott Sporer,12 Louis Stryker,13Marat Turgunbaev,14 Barry Brause,1 Antonia F. Chen,15 Jeremy Gililland,16 Mark Goodman,17Arlene Hurley-Rosenblatt,18 Kyriakos Kirou,1 Elena Losina,19 Ronald MacKenzie,1Kaleb Michaud,20 Ted Mikuls,21 Linda Russell,1 Alexander Sah,22 Amy S. Miller,14Jasvinder A. Singh,23 and Adolph Yates17Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to the recommendations within this guideline to be voluntary, with the ultimate deter- mination regarding their application to be made by the physician in light of each patient’s individual circumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed and endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice. ACR recommendations are not intended to dictate payment or insurance decisions. These recommendations cannot adequately convey all uncertainties and nuances of patient care.The American College of Rheumatology is an independent, professional, medical and scientific society that does not guarantee, warrant, or endorse any commercial product or service.Objective. This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-basedguideline for the perioperative management of antirheu- matic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing5Vinod Dasa, MD: Louisiana State University, New Orleans; 6Michael George, MD: University of Pennsylvania, Philadelphia; 7Ora Gewurz- Singer, MD: University of Michigan, Ann Arbor; 8Jon T. Giles, MD, MPH: Columbia University, New York, New York; 9Beverly Johnson, MD: Albert Einstein College of Medicine, Bronx, New York; 10Steve Lee, DO: Kaiser Permanente, Fontana, California; 11Michael A. Mont, MD: Cleveland Clinic, Cleveland, Ohio; 12Scott Sporer, MD: Midwest Orthopaedics at Rush, Chicago, Illinois; 13Louis Stryker, MD: University of Texas Medical Branch, Galveston; 14Marat Turgunbaev, MD, MPH, Amy S. Miller: American College of Rheu- matology, Atlanta, Georgia; 15Antonia F. Chen, MD, MBA: Rothman1Knee Center,...
