Influence of methotrexate on the frequency of postoperative infectious complications in patients with rheumatoid arthritis

J Rheumatol. 1993 Jul;20(7):1129-32.


Objective: To evaluate the influence of methotrexate (MTX) on the frequency of postoperative complications in patients with rheumatoid arthritis (RA).

Methods: We conducted a randomized unblinded prospective study in 64 patients with RA treated with MTX and who underwent orthopedic surgery. Two groups of patients were constituted: in Group A (32 patients), MTX was interrupted 7 days before the surgery; in Group B (32 patients), MTX was not discontinued.

Results: Fifty surgical procedures were performed in Group A and 39 procedures in Group B. No postoperative infection was observed in any group. A prolonged wound healing was noticed in 6 cases in Group A and in 4 cases in Group B (not significant).

Conclusion: We suggest that the interruption of MTX is not required in patients with RA when an orthopedic surgical treatment is planned. However a large prospective study is needed to make a definitive conclusion.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / surgery
  • Female
  • Humans
  • Incidence
  • Male
  • Methotrexate / adverse effects
  • Methotrexate / pharmacology*
  • Methotrexate / therapeutic use
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Prospective Studies
  • Wound Healing / physiology
  • Wound Infection / epidemiology*


  • Methotrexate