Reumatizam, Vol. 65 No. 2, 2018.
Review article
OSOBITOSTI UGRADNJE ENDOPROTEZA KUKA I KOLJENA KOD BOLESNIKA S REUMATOIDNIM ARTRITISOM
Domagoj Delimar
; Clinic for orthopedics of KBC Zagreb, School of Medicine University of Zagreb, Croatia
Krešimir Crnogaća
; Clinic for orthopedics of KBC Zagreb, School of Medicine University of Zagreb, Croatia
Zoran Sulje2
; Clinic for orthopedics of KBC Zagreb, School of Medicine University of Zagreb, Croatia
Abstract
Reumatoidni artritis (RA) kronična je, progresivna autoimunosna bolest. Usprkos liječenju tijekom vremena razvija se oštećenje zglobova. U otprilike 25% bolesnika s RA tijekom života potrebna je ugradnja totalne endoproteze (TEP). Potreba za operacijskim liječenjem u obliku ugradnje TEP-a nastupa kad medikamentna terapija više ne može
kontrolirati osnovnu bolest. Cilj kirurškog liječenja jesu kontrola boli i restauracija funkcije oštećenog zgloba. Osim standardne prijeoperacijske obrade, valja obratiti pozornost i na stanje cervikalne kralježnice, eventualne kardiovaskularne popratne bolesti te na medikamentnu terapiju kojom se kontrolira osnovna bolest. Pri ugradnji TEP-a kuka vrlo dobri rezultati postižu se i primjenom cementnih i bescementnih endoproteza, dok se za koljeno primjenjuju gotovo samo cementne endoproteze. Pri ugradnji totalnih endoproteza komplikacije se još i nadalje javljaju nešto češće nego kod primarnih osteoartritisa. Periprotetička infekcija teška je komplikacija koja se javlja u 1 – 3% slučajeva. Ugradnja totalnih endoproteza sigurna je i pouzdana metoda kontrole boli i funkcionalnog oporavka kod bolesnika s RA.
Keywords
Rheumatoid arthritis (RA) is a chronic; progressive autoimmune disease. Despite treatment; destruction of joints develops over time. Approximately 25% of all patients with RA are required to have total joint arthroplasty during their lifetime. Th e need for operative treatment occurs when conservative therapy cannot control the underlying disease. The goal of surgical treatment is pain control and restoration of function of the affected joint. In addition to the standard preoperative preparation; attention should also be paid to the condition of the cervical spine; possible cardiovascular disease; and drugs used in the therapy of the underlying disease. In total hip replacement procedures very good results are achieved by uncemented and cemented endoprosthesis; while in the knee cemented endoprosthesis is almost exclusively used. Complications still occur more oft en than in patients with primary osteoarthritis. Periprosthetic joint infection is a serious complication occurring in about 1-3% of all cases. Implantation of a total endoprosthesis is a safe and reliable method of pain control and functional recovery in patients with RA.
Hrčak ID:
212233
URI
Publication date:
6.12.2018.
Visits: 4.557 *