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Total knee arthroplasty in patients with psoriasis
S H Stern1, J N Insall, R E Windsor
1Hospital for Special Surgery, New York, NY 10021.
Clinical Orthopaedics and Related Research
|November 1, 1989
Summary
Patients with progressive psoriasis face higher infection risks after total joint arthroplasty. Strict precautions, especially meticulous skin care, are crucial during perioperative periods and long-term follow-up to prevent joint sepsis.
Area of Science:
- Orthopedic surgery
- Dermatology
- Infectious disease
Background:
- Psoriasis is a chronic inflammatory skin condition.
- Patients with psoriasis, particularly progressive forms, may have altered immune responses.
- Total joint arthroplasty (TJA) involves significant surgical procedures with inherent infection risks.
Purpose of the Study:
- To highlight the increased risk of joint sepsis in patients with progressive psoriasis undergoing TJA.
- To emphasize the need for heightened perioperative and long-term management strategies.
- To underscore the importance of dermatologic care in this patient population.
Main Methods:
- Review of existing literature on psoriasis and TJA outcomes.
- Analysis of infection rates in TJA patients with and without psoriasis.
- Clinical recommendations based on identified risks.
Main Results:
- Patients with progressive psoriasis demonstrate a statistically significant increase in infection rates post-TJA.
- Joint sepsis is a major concern requiring proactive management.
- Topical corticosteroid use and dermatologic treatment require careful consideration.
Conclusions:
- Meticulous perioperative and long-term follow-up care is essential for TJA patients with progressive psoriasis.
- Proactive skin care and judicious use of dermatologic treatments are critical to mitigate infection risk.
- Preventing joint sepsis in this vulnerable group requires a multidisciplinary approach.