Kingsberg Jessica G, Halpern Alan A, Hill Brian C
Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA.
Am J Orthop (Belle Mead NJ). 2016 Jan;45(1):E1-6.
Increasing numbers of patients who have undergone bariatric surgery are now presenting to orthopedic surgeons for elective arthroplasties. In addition, orthopedic surgeons themselves are referring more patients for consideration of bariatric surgery in anticipation of future elective procedures. Although the full effects of bariatric surgery on metabolism are not yet known, the altered digestion associated with these surgeries poses several issues for orthopedic surgeons. In this article, we address 3 aspects of care of this class of patient: review of the most commonly performed procedures and their metabolic consequences; suggested preoperative assessment of bariatric patients for any conditions that should be corrected before surgery; and evaluation of outcomes of elective procedures performed after bariatric surgery. Awareness of the unique characteristics of this group of patients helps minimize the potential for complications of planned orthopedic surgeries.
越来越多接受过减肥手术的患者现在前来整形外科医生处接受择期关节置换手术。此外，整形外科医生自己也在推荐更多患者考虑进行减肥手术，以预期未来的择期手术。尽管减肥手术对新陈代谢的全面影响尚不清楚，但与这些手术相关的消化改变给整形外科医生带来了几个问题。在本文中，我们讨论这类患者护理的三个方面：回顾最常见的手术及其代谢后果；建议对减肥患者进行术前评估，以确定手术前应纠正的任何状况；以及评估减肥手术后进行的择期手术的结果。了解这类患者的独特特征有助于将计划中的整形外科手术并发症的可能性降至最低。
