Patients with systemic lupus erythematosus (SLE) have multisystem disease and thus an increased risk for multiple perioperative complications, including wound infection, renal insufficiency, cardiovascular events, and pulmonary embolus. There is a two- to sevenfold higher mortality rate for SLE patients undergoing both nonelective and elective hip and knee surgery compared to rheumatoid arthritis (RA) patients and controls independent of major medical comorbidities [1]. Additional studies have demonstrated that patients with SLE had a higher prevalence of preoperative coexisting medical conditions and postoperative major complications [2] as well as short-term perioperative outcomes [3].