Optimización preoperatoria del paciente antes de una artroplastia de cadera o rodilla: parte 1

• Leonel Perez Alamino ^[1] ; Fernando Tillet ^[2] ; Eduardo Bochatey ^[2] ; Fernando Lopreite ^[1]
  1. [1] Hospital Británico de Buenos Aires

     Hospital Británico de Buenos Aires

     Argentina

     
  2. [2] Grupo GRECARO, Argentina
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 87, Nº. 5, 2022 (Ejemplar dedicado a: ACARO), págs. 721-726
• Idioma: español
• DOI: 10.15417/issn.1852-7434.2022.87.5.1658
• Títulos paralelos:
  • Preoperative Patient Optimization Before Hip or Knee Arthroplasty: Part 1
• Enlaces
  • Texto completo  1    2  
• Dialnet Métricas: 2 Citas
• Resumen
  • español

    Las artroplastias de cadera y rodilla son estrategias que han demostrado ser efectivas en el tratamiento de la patología degenerativa articular. El reemplazo articular mejora la calidad de vida de la mayoría de los pacientes cuando el tratamiento conservador falla. Sin embargo, estas son cirugías mayores que conllevan un riesgo significativo de complicaciones, incluyendo la necesidad de una revisión. El propósito de este artículo es analizar los factores de riesgo modificables del paciente antes de la cirugía, a finde disminuir el riesgo de complicaciones posoperatorias. Estudios recientes han descripto ciertos factores de riesgo modificables, inherentes al paciente y que incrementan la posibilidad de complicaciones posoperatorias luego de un reemplazo articular de cadera o rodilla. Estos incluyen obesidad, malnutrición, tabaquismo, diabetes, anemia, deficiencia de vitamina D, consumo de opioides, artropatías inflamatorias, insuficiencia renal crónica y colonización por estafilococco meticilino-resistente. Si conseguimos optimizar estas condiciones durante el preoperatorio, reduciremos el riesgo de complicaciones posoperatorias.

  • English

    Hip and knee arthroplasties are well-known effective strategies for joint osteoarthritis. Joint replacement reliably improves quality of life for most patients when non-operative measures have failed. However, these are major surgeries that carry significant risks, including the need for revision surgery. The purpose of this article is to discuss preoperative modifiable risks parameters of the patient prior to joint replacement to decrease complication risks. Recent studies have described several modifiable factors that increase the risk of postoperative complications following hip and knee replacement. These include obesity, malnutrition, tobacco use, diabetes, anaemia, vitamin D deficiency, opioid use, inflammatory arthropathy, kidney chronic insufficiency and meticilin-resistant staphylococci colonization. If we achieve preoperative optimization of these conditions, we should minimize the risk of adverse outcomes.

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