Tumour necrosis factor   antagonists and early postoperative complications in patients with inflammatory joint disease undergoing elective orthopaedic surgery

Tumour necrosis factor α (TNFα) antagonists are now established as therapeutic agents for active rheumatoid arthritis (RA) resistant to conventional drug treatment. 1 However, they decrease resistance to infection, including unusual infections such as tuberculosis, 2, 3 and in an experimental setting have been shown to impair wound healing. 4 Previous studies have shown that TNFα antagonists do not increase the risk of postoperative surgical complications in patients with Crohn's disease who undergo resective bowel surgery, 5, 6 but the safety of these drugs in patients with RA who undergo elective orthopaedic surgery has not yet been established. [...]in this small study there is no evidence that anti-TNF drug treatment, whether discontinued or continued, increased either the rate of infection or the complication rate.