Single stage bilateral total hip arthroplasty – 10 years of experience

Aleksandar Radunović; Vesna Radunović; Srdjan Starčević; Goran Lekić; Maja Vulović

doi:10.2298/VSP180226075R

Aleksandar Radunović Military Medical Academy, Clinic for Orthopedic Surgery and Trumatology, Belgrade, Serbia
Vesna Radunović Pharmacy Belgrade, Belgrade, Serbia
Srdjan Starčević Military Medical Academy, Clinic for Orthopedic Surgery and Trumatology, Belgrade, Serbia
Goran Lekić Military Medical Academy, Clinic for Orthopedic Surgery and Trumatology, Belgrade, Serbia
Maja Vulović University of Kragujevac, Faculty of Medical Sciences, Department of Anatomy and Forensic Medicine, Kragujevac, Serbia

DOI: https://doi.org/10.2298/VSP180226075R

Ključne reči: artroplastika kuka, hirurgija, operativne procedre, komorbiditet, postoperativne komplikacije, srbija

Sažetak

Uvod/ Cilj. Koksartroza je hronično degenerativno oboljenje koje se javlja kod oko 4% populacije, a procenjuje se da oko 42% bolesnika ima bilateralno oboljenje. Bolesnicima sa bilateralnom koksartrozom može se učiniti artroplastika oba kuka u jednom ili dva akta. Cilj ovog rada bio je prezentacija našeg iskustva sa izvođenjem simultane bilateralne artroplastike kukova i preporuka za izvođenje procedure kod bolesnika sa adekvatnom indikacijom. Metode. Obradili smo podatke za 113 bolesnika oba pola koji su operisani na Klinici za ortopedsku hirurgiju i traumatologiju Vojnomedicinske akademije u Beogradu, Srbija, u periodu od 2005. do 2015. godine, a kojima je učinjena artroplastika oba kuka u jednom aktu. Kod svih bolesnika je primenjena identična operativna tehnika uz identičnu standardnu antibiotsku i tromboprofilaktičku terapiju. Postoperativno praćenje bolesnika je iznosilo 30 dana. Rezultati. Prosečna starost bolesnika bila je 56 ± 10.2 godina; muškog pola je bilo 45 (39,8%), a ženskog pola 68 (60,2%) bolesnika. Primarna koksartroza je bila etiološki faktor kod većine bolesnika, njih 69 (61,1%). Prosečna dužina hospitalizacije postoperativno bila je 10,3 dana (od 3 do 34 dana). Zabeležili smo sledeće komplikacije: jedna luksacija endoproteze, jedna duboka infekcija i jedna tromboza vena noge. Nije bilo smrtnih slučajeva. Najveći broj operisanih bolesnika pripadao je grupama American Society of Anesthesiologists (ASA) skoring sistema 1-3. Prosečna količina transfuzionisane krvi iznosila je 1 275 mL (od 300 do 2 830 mL). Zaključak. Bilateralna artroplastika kukova u jednom aktu može se izvoditi rutinski i bezbedno u ustanovama koje omogućavaju multidisciplinarni pristup i adekvatnu selekciju bolesnika. Podaci iz naše studije ukazuju na povećanu potrebu za supstitucijom krvi što naglašava potrebu za uvođenjem savremenih principa perioperativne kontrole gubitka krvi. Učestalost komplikacija zabeleženih u ovoj studiji je u okviru stepena učestalosti saopštenih u literaturi koja se bavi artroplastikama kukova.

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Bilateralna totalna artroplastika kukova u jednom aktu – desetogodišnje iskustvo

Sažetak

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