Postoperative results of rheumatoid arthritis patients on methotrexate at the time of reconstructive surgery of the hand.

We conducted a retrospective chart review examining the frequency of local postoperative infection and poor wound healing of 15 methotrexate-treated rheumatoid arthritis patients undergoing 155 procedures during 39 surgeries. The patients were compared to a group of rheumatoid patients not on methotrexate who underwent similar reconstructive surgery of the hand. The patients taking methotrexate were followed postoperatively for a minimum of 10 weeks, with a mean follow-up time of 1 year, 42 weeks. There were no postoperative complications that would lead to the belief that the administration of methotrexate results in poor wound healing or leaves the patient more susceptible to postoperative infection. Our findings and a review of the literature support a continuation of methotrexate therapy in rheumatoid arthritis patients scheduled for reconstructive surgery of the hand and wrist.