Journal of AdvancedMedical and Dental Sciences Research

Background: This study was designed to determine whether continuing the treatment with methotrexate increases the risk of any postoperative infections or additional surgical complications in patients suffering from rheumatoid arthritis (RA) followed up for 6 months after elective orthopaedic surgery. Methods:  172 patients suffering from RA who were supposed to undergo elective orthopaedic surgery were selected. Patients receiving methotrexate were randomly allotted to groups that either continued methotrexate therapy (group A) or the ones who discontinued the use of methotrexate one month before and after surgery (group B). The rate of complications arising was compared with complications occurring in another group of 160 patients suffering from RA (group C) who did not receive methotrexate and underwent elective orthopaedic surgery. The main outcome measures recorded were signs of postoperative infection, including redness, amount of discharge, systemic infection, and frequency of wound dehiscence. Results: Surgical complications or infection frequency in group A was found to be significantly lesser than that in either group B (p = 0.0045) or group C (p=0.038). Analysis of the overall rate of complications showed that methotrexate, whether continued or discontinued before surgery, did not increase the incidence of complications in the patients with RA who underwent elective orthopaedic surgery. Conclusion: Methotrexate therapy was not found to increase the risk of infections or surgical complications occurring in patients with RA within 6 months of elective orthopaedic surgery.
Key words: Orthopaedic surgery; Rheumatoid Arthritis, Methotrexate; postoperative surgical complications.