Preoperative Evaluation and Management of Patients Receiving Biologic Therapies



Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


The preoperative care of patients undergoing orthopedic surgery and treated with biologic agents is of great significance.
Perioperative use of biologic agents could lead to such complications as infection and delayed postoperative wound
healing. This narrative review aimed to evaluate the current information on the use of biologic agents in patients
undergoing orthopedic surgery, determine the rate of associated postoperative complications, and identify the
appropriate time for the continuation or discontinuation of biologic therapy in these patients. It can be stated that
all biologic agents increase the risk of infections depending on their half-lives. Biologic agents are suggested to be
withheld for at least twice their half-lives before major surgeries. However, in case of minor operations, they can be
continued given the low risk of infection and impaired wound healing in these cases.
Level of evidence: I


Main Subjects