Preoperative Evaluation and Management of Patients Receiving Biologic Therapies

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 woundhealing. This narrative review aimed to evaluate the current information on the use of biologic agents in patientsundergoing orthopedic surgery, determine the rate of associated postoperative complications, and identify theappropriate time for the continuation or discontinuation of biologic therapy in these patients. It can be stated thatall biologic agents increase the risk of infections depending on their half-lives. Biologic agents are suggested to bewithheld for at least twice their half-lives before major surgeries. However, in case of minor operations, they can becontinued given the low risk of infection and impaired wound healing in these cases.Level of evidence: I

Keywords:

B cell inhibitor , Biologic therapy , Preoperative care , T cell inhibitor , TNF-α inhibitor