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肥胖患者全膝关节置换术治疗中的挑战与并发症

Challenges and Complications in Treating Total Knee Arthroplasty in Morbidly Obese Patients.

作者信息

Bocea Bogdan A, Roman Mihai D, Fleaca Radu S, Ion Nicolas C, Necula Radu, Diconi Alexandru F, Mihaila Romeo G

机构信息

Biophysics, Lucian Blaga University, Sibiu, ROU.

Orthopedics and Traumatology, County Clinical Emergency Hospital, Sibiu, ROU.

出版信息

Cureus. 2024 Oct 14;16(10):e71433. doi: 10.7759/cureus.71433. eCollection 2024 Oct.

Abstract

The number of total hip and total knee replacements has increased steadily each year. Today, they are routinely performed all over the world. The increasing prevalence of obesity has led to an increase in the number of total knee arthroplasties (TKAs) performed in patients with a higher body mass index (BMI) and also has a higher rate of complications. Possible complications are infection, instability, misalignment, osteolysis, or fracture. Revision arthroplasty can be challenging due to bone defects, ligament instability, and difficulty in fixation. We present the case of a 66-year-old morbidly obese patient who underwent TKA. After the operation, infection and a mechanical complication of periprosthetic fracture of the tibial component occurred. The infection made the treatment more difficult. The patient had to undergo several surgeries in several stages to address the post-surgical complications. TKA in obese patients leads to a higher risk of postoperative complications.

摘要

全髋关节置换术和全膝关节置换术的数量每年都在稳步增加。如今,它们在世界各地都常规开展。肥胖患病率的上升导致身体质量指数(BMI)较高的患者接受全膝关节置换术(TKA)的数量增加,且并发症发生率也更高。可能的并发症包括感染、不稳定、排列不齐、骨溶解或骨折。由于骨缺损、韧带不稳定和固定困难,翻修关节成形术可能具有挑战性。我们介绍了一例66岁病态肥胖患者接受TKA的病例。术后发生了感染以及胫骨部件假体周围骨折的机械并发症。感染使治疗更加困难。患者不得不分几个阶段接受多次手术来处理术后并发症。肥胖患者的TKA术后并发症风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2696/11472769/eb8aa1ad6b2f/cureus-0016-00000071433-i01.jpg

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