Total Joint Arthroplasty During Ramadan

Jun 2, 2026The Journal of bone and joint surgery. American volume

Joint Replacement Surgery During Ramadan: Effects on Patients and Surgeons Around the Operation

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Abstract

Daily fasting during Ramadan can exceed 14 to 18 hours, impacting safety in total joint arthroplasty (TJA).

Prolonged fasting may lead to changes in hydration and blood sugar levels.
Alterations in circadian rhythm and sleep patterns could affect patient recovery and outcomes.
Elective TJA is not automatically discouraged during Ramadan but necessitates careful evaluation.
A structured approach to perioperative planning and patient education is advised.

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Total joint arthroplasty (TJA) is increasingly performed in a global patient population that includes individuals observing prolonged daily fasting during Ramadan, a lunar calendar-based observance occurring over 29 to 30 consecutive days. Daily fasting may exceed 14 to 18 hours depending on geography and season, producing measurable alterations in hydration, glycemic variability, circadian rhythm, and sleep architecture that intersect with perioperative safety in TJA. This article synthesizes the physiologic and perioperative considerations, examines the implications for patients and surgeons, and proposes a framework for risk stratification, shared decision-making, and perioperative management. Elective TJA during Ramadan is not inherently contraindicated but requires structured assessment, perioperative planning, and patient counseling.

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Total Joint Arthroplasty During Ramadan

Abstract

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