Cerrahi Sonrası Oluşabilecek Komplikasyonlar ve Tromboproflaksi
Özet
Obezite, dünya çapında en büyük sağlık problemlerinden biridir. Obezite birçok sistemik hastalıklara sebep olabilmekte ve ortopedik açıdan da önemli hastalıklara yatkınlık oluşturmakta, ameliyat esnasında ve ameliyat sonrasında da birçok komplikasyonlara yol açabilmektedir. Obezitede Diabetes Mellitus (DM), kardiyovasküler hastalıklar (KVH), serobrovasküler hastalıklar, hipertansiyon hatta kanser gibi hastalıklarla beraber görülmesinin yanında ortopedik hastalıkların oluşmasında ve ameliyat sonrası komplikasyonları arttırabilmektedir. Özellikle, osteoartrit gelişmesine önemli derecede neden olurken, ameliyat sonrası rehabilitasyon yetersizliği, enfeksiyon gelişimi, derin ven trombozu ve pulmoner emboli gibi hayatı tehdit eden sorunlar meydana gelebilmektedir. Sonuç olarak, obezitenin önlenmesiyle hastalıkların gelişiminin önüne geçilirken ameliyat sonrası oluşabilecek komplikasyonların da azalmasına yardımcı olabilmektedir.
Referanslar
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Başdelioğlu, K. Effects of body mass index on outcomes of total knee arth- roplasty. European Journal of Orthopaedic Surgery & Traumatology. 2021; 31(3), 595-600.
Wilson CJ, Georgiou KR, Oburu E et al. Surgical site infection in overwei- ght and obese total knee arthroplasty patients. J Orthop. 2018;15:328–332.
Järvenpää, J., Kettunen, J., Kröger, H., et al. Obesity may impair the ear- ly outcome of total knee arthroplasty a prospective study of 100 patients. Scandinavian Journal of Surgery. 2010;99(1), 45-49.
Dieppe PA, Lohmander SL. Pathogenesis and management of pain in oste- oarthritis. The Lancet. 2005; 365:965-973.
Changulani, M., Kalairajah, Y., Peel, T., et al. The relationship between obe- sity and the age at which hip and knee replacement is undertaken. The Journal of Bone and Joint Surgery. British Volume. 2008; 90(3), 360-363.
Spector TD, Hart DJ, Byrne J et al. Definition of osteoarthritis of the knee for epidemiological studies. Ann Rheum Dis 1993; 52: 790-4.
Lohmander L.S., Gerhardsson de Verdier M., Rollof J., et al. Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study. Annals of the Rheuma- tic Diseases. 2009; 68(4): 490–6.)
Hochberg MC, Lethbridge-Cejku M, Scott WW Jr, et al. The association of body weight, body fatness and body fat distribution with osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging. The Jour- nal of rheumatology. 1995; 22(3): 488–93.
Coggon D, Reading I, Croft P et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001; 25: 622-7
Bookman, J. S., Schwarzkopf, R., Rathod, P., et al. Obesity: the modifiable risk factor in total joint arthroplasty. Orthopedic Clinics. 2018; 49(3), 291- 296.
Telatar, A. Total diz artroplastisi sonrasında gelişen diz instabilitelerinde etkili risk faktörlerinin analizi ve tedavi algoritması. Tıpta Uzmanlık Tezi. İstanbul; 2018.
Bordini, B., Stea, S., Cremonini, S., et al. Relationship between obesity and early failure of total knee prostheses. BMC Musculoskeletal Disorders. 2009; 10(1), 1-8.
Bakırhan,S., Ünver,B., Karatosun,V. A. Total kalça artroplastili hastalarda ameliyat öncesi vücut ağırlığı ameliyat sonrası erken dönem fonksiyonel aktiviteleri etkiler mi?. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2017; 28(3), 188-194.
Gillespie, G. N., & Porteous, A. J. Obesity and knee arthroplasty. The Knee. 2007; 14(2), 81-86.
Nuñez, M., Lozano, L., Nuñez, E., Segur, J. M., & Sastre, S. Factors influ- encing health-related quality of life after TKA in patients who are obese. Clinical Orthopaedics and Related Research®. 2011; 469(4), 1148-1153.
Foran JRH, Mont MA, Etienne G et al. The outcome of total knee arthrop- lasty in obese patients. J Bone Joint Surg Am. 2004; 86:1609-1615)
Foran JRH, Mont MA, Rajadhyaksha AD et al. Total knee arthroplasty in obese patients: A comparison with a matched control group. J Arthroplasty. 2004;19:817-824
Başdelioğlu, K. Effects of body mass index on outcomes of total knee arth- roplasty. European Journal of Orthopaedic Surgery & Traumatology. 2021; 31(3), 595-600.
Dowsey, M. M., & Choong, P. F. Obese diabetic patients are at substantial risk for deep infection after primary TKA. Clinical Orthopaedics and Rela- ted Research®. 2009; 467(6), 1577-1581.
Chesney D, Sales J, Elton R et al: Infection after knee arthroplasty. A pros- pective study of 1509 cases. J Arthroplasty. 2008; 23:355-359.
Cecen, G. S., Gulabi, D., Yanik, E., Pehlivanoglu, G., Bekler, H., & Elmali,
N. U. R. Z. A. T. Effect of BMI on the clinical and radiological outcomes of pilon fractures. Acta Orthopaedica et Traumatologica Turcica. 2014; 48(5), 570-575.
Dowsey, M. M., & Choong, P. F. Obesity is a major risk factor for prosthetic infection after primary hip arthroplasty. Clinical orthopaedics and related research. 2008; 466(1), 153-158.
Namba RS, Inacio MCS, Paxton EW. Risk factors associated with deep sur- gical site infections after primary total knee arthroplasty: an analysis of 56,216 knees. J Bone Joint Surg Am. 2013;95(9): 775–82
Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, Ortel TL, Pauker SG, Colwell CW Jr.. Prevention of VTE in orthopedic sur- gery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl): e278S-e325S
Parvizi J, Huang R, Raphael IJ, Arnold WV, Rothman RH. Symptomatic pulmonary embolus after joint arthroplasty: stratification of risk factors. Clin Orthop Relat Res. 2014;472(3):903–12
Mantilla, C. B., Horlocker, T. T., Schroeder, D. R., Berry, D. J., & Brown,
D. L. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthrop- lasty. The Journal of the American Society of Anesthesiologists. 2003; 99(3), 552-560.
Johanson NA, Lachiewicz PF, Lieberman JR, et al. Prevention of sympto- matic pulmonary embolism in patients undergoing total hip or knee arth- roplasty. J Am Acad Orthop Surg. 2009;17(3):183–96
National Guideline Centre (UK). Venous thromboembolism in over 16s: Reducing the risk of hospital-acquired deep vein thrombosis or pulmo- nary embolism. London: National Institute for Health and Care Excellence (NICE). 2018; Mar. PMID: 29697228.
Ceylan, HH ve Azboy, İ. Ortopedik ve venöz tromboz profilaksi ajanları: farmakolojik operasyonlar. TOTBİD DERGİSİ, 2019;18:489–499.
Kerkhoffs G.M., Servien E., Dunn W., et al. The influence of obesity on the complication rate and outcome of total knee arthroplasty: a meta-analysis and systematic literature review. J Bone Joint Surg Am 2012;94(20):1839– 1844.
Coşkun, A., Kehribar, D.Y(Ed). Obeziteye Multidisipliner Yaklaşım. Anka- ra: Akademisyen Kitabevi; 2020.
Miric A, Lim M, Kahn B, et al. Perioperative morbidity following total knee arthroplasty among obese patients. J Knee Surg. 2002;15:77.
Öz, B., Karataş, A., Akar, Z. A., et al. Obezite ve kas-iskelet sistemi. Fırat Med J. 2018; 23, 42-47.
Schwarzkopf, R., Thompson, S. L., Adwar, S. J., et al. Postoperative compli- cation rates in the “super-obese” hip and knee arthroplasty population. The Journal of arthroplasty. 2012;27(3), 397-401.
Başdelioğlu, K. Effects of body mass index on outcomes of total knee arth- roplasty. European Journal of Orthopaedic Surgery & Traumatology. 2021; 31(3), 595-600.
Wilson CJ, Georgiou KR, Oburu E et al. Surgical site infection in overwei- ght and obese total knee arthroplasty patients. J Orthop. 2018;15:328–332.
Järvenpää, J., Kettunen, J., Kröger, H., et al. Obesity may impair the ear- ly outcome of total knee arthroplasty a prospective study of 100 patients. Scandinavian Journal of Surgery. 2010;99(1), 45-49.
Dieppe PA, Lohmander SL. Pathogenesis and management of pain in oste- oarthritis. The Lancet. 2005; 365:965-973.
Changulani, M., Kalairajah, Y., Peel, T., et al. The relationship between obe- sity and the age at which hip and knee replacement is undertaken. The Journal of Bone and Joint Surgery. British Volume. 2008; 90(3), 360-363.
Spector TD, Hart DJ, Byrne J et al. Definition of osteoarthritis of the knee for epidemiological studies. Ann Rheum Dis 1993; 52: 790-4.
Lohmander L.S., Gerhardsson de Verdier M., Rollof J., et al. Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study. Annals of the Rheuma- tic Diseases. 2009; 68(4): 490–6.)
Hochberg MC, Lethbridge-Cejku M, Scott WW Jr, et al. The association of body weight, body fatness and body fat distribution with osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging. The Jour- nal of rheumatology. 1995; 22(3): 488–93.
Coggon D, Reading I, Croft P et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001; 25: 622-7
Bookman, J. S., Schwarzkopf, R., Rathod, P., et al. Obesity: the modifiable risk factor in total joint arthroplasty. Orthopedic Clinics. 2018; 49(3), 291- 296.
Telatar, A. Total diz artroplastisi sonrasında gelişen diz instabilitelerinde etkili risk faktörlerinin analizi ve tedavi algoritması. Tıpta Uzmanlık Tezi. İstanbul; 2018.
Bordini, B., Stea, S., Cremonini, S., et al. Relationship between obesity and early failure of total knee prostheses. BMC Musculoskeletal Disorders. 2009; 10(1), 1-8.
Bakırhan,S., Ünver,B., Karatosun,V. A. Total kalça artroplastili hastalarda ameliyat öncesi vücut ağırlığı ameliyat sonrası erken dönem fonksiyonel aktiviteleri etkiler mi?. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2017; 28(3), 188-194.
Gillespie, G. N., & Porteous, A. J. Obesity and knee arthroplasty. The Knee. 2007; 14(2), 81-86.
Nuñez, M., Lozano, L., Nuñez, E., Segur, J. M., & Sastre, S. Factors influ- encing health-related quality of life after TKA in patients who are obese. Clinical Orthopaedics and Related Research®. 2011; 469(4), 1148-1153.
Foran JRH, Mont MA, Etienne G et al. The outcome of total knee arthrop- lasty in obese patients. J Bone Joint Surg Am. 2004; 86:1609-1615)
Foran JRH, Mont MA, Rajadhyaksha AD et al. Total knee arthroplasty in obese patients: A comparison with a matched control group. J Arthroplasty. 2004;19:817-824
Başdelioğlu, K. Effects of body mass index on outcomes of total knee arth- roplasty. European Journal of Orthopaedic Surgery & Traumatology. 2021; 31(3), 595-600.
Dowsey, M. M., & Choong, P. F. Obese diabetic patients are at substantial risk for deep infection after primary TKA. Clinical Orthopaedics and Rela- ted Research®. 2009; 467(6), 1577-1581.
Chesney D, Sales J, Elton R et al: Infection after knee arthroplasty. A pros- pective study of 1509 cases. J Arthroplasty. 2008; 23:355-359.
Cecen, G. S., Gulabi, D., Yanik, E., Pehlivanoglu, G., Bekler, H., & Elmali,
N. U. R. Z. A. T. Effect of BMI on the clinical and radiological outcomes of pilon fractures. Acta Orthopaedica et Traumatologica Turcica. 2014; 48(5), 570-575.
Dowsey, M. M., & Choong, P. F. Obesity is a major risk factor for prosthetic infection after primary hip arthroplasty. Clinical orthopaedics and related research. 2008; 466(1), 153-158.
Namba RS, Inacio MCS, Paxton EW. Risk factors associated with deep sur- gical site infections after primary total knee arthroplasty: an analysis of 56,216 knees. J Bone Joint Surg Am. 2013;95(9): 775–82
Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, Ortel TL, Pauker SG, Colwell CW Jr.. Prevention of VTE in orthopedic sur- gery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl): e278S-e325S
Parvizi J, Huang R, Raphael IJ, Arnold WV, Rothman RH. Symptomatic pulmonary embolus after joint arthroplasty: stratification of risk factors. Clin Orthop Relat Res. 2014;472(3):903–12
Mantilla, C. B., Horlocker, T. T., Schroeder, D. R., Berry, D. J., & Brown,
D. L. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthrop- lasty. The Journal of the American Society of Anesthesiologists. 2003; 99(3), 552-560.
Johanson NA, Lachiewicz PF, Lieberman JR, et al. Prevention of sympto- matic pulmonary embolism in patients undergoing total hip or knee arth- roplasty. J Am Acad Orthop Surg. 2009;17(3):183–96
National Guideline Centre (UK). Venous thromboembolism in over 16s: Reducing the risk of hospital-acquired deep vein thrombosis or pulmo- nary embolism. London: National Institute for Health and Care Excellence (NICE). 2018; Mar. PMID: 29697228.
Ceylan, HH ve Azboy, İ. Ortopedik ve venöz tromboz profilaksi ajanları: farmakolojik operasyonlar. TOTBİD DERGİSİ, 2019;18:489–499.
Sayfalar
15-24
Yayınlanan
3 Şubat 2023
Telif Hakkı (c) 2023 Akademisyen Kitap Portalı
Lisans
LisansNasıl Atıf Yapılır
1.
Altun İ. Cerrahi Sonrası Oluşabilecek Komplikasyonlar ve Tromboproflaksi. Içinde: Peker G, editör. Obezite ve Ortopedik Hastalıklar [Internet]. Türkiye: Akademisyen Yayınevi Kitap DOI Portalı; 2023 [a.yer 16 Temmuz 2026]. ss. 15-24. Erişim adresi: https://omp35.books.akademisyen.net/index.php/akya/catalog/book/2465/chapter/13823
