Obesity and orthopedic surgery, or else do mechanical complications of obesity exist?

Česká verzia

Authors: Štěpán Svačina
Published in the journal: Vnitř Lék 2015; 61(6): 571-573
Category:

Předneseno na mezioborovém sympoziu s postgraduálním zaměřením „Diabetik – společný pacient diabetologa a ortopeda“ 10. října 2014 v Hradci Králové

Summary

Arthroses of weight-bearing joints and vertebrogenic problems are characteristic diseases of the obese. However the extreme risk is associated in particular with the combination with metabolic syndrome. Arthroses of bearing joints thus do not only present a mechanical complication of obesity, but also a metabolic complication. Similarly, the risk of venous thromboembolism which involves all orthopedic surgeries, is associated with both a rising BMI and hormonal condition (use of hormones and the like.). A joint replacement surgery can be typically performed on patients with a weight of up to 90 kg or BMI below 30. A preparation aimed at decreasing BMI to reach these values significantly reduces the risk of postoperative complications. However it is also necessary for the patient to maintain the reduced weight.

Key words:
diabetes mellitus – knee joint replacement – hip joint replacement – mechanical complications of obesity – metabolic complications of obesity – metabolic syndrome – obesity – surgery related risk – venous tromboembolizmus

Zdroje

1. Svačina Š. Obezitologie a teorie metabolického syndromu. Praha: Triton 2013. ISBN 978–80–7387–678–4.

2. Padwal RS et al. Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. CMAJ 2011; 183(14): E1059-E1066.

3. Svačina Š et al. Metabolický syndrom. Praha: Triton 2006. ISBN 80–7254–782–8.

4. Lee S et al. Obesity, metabolic abnormality, and knee osteoarthritis: A cross-sectional study in Korean women. Mod Rheumatol 2015; 25(2): 292–297.

5. Shaw KA, Edelman AB. Obesity and oral contraceptives. Best Pract Res Clin Endocr Metab 2013; 27(1): 55–65.

6. Grubor P et al. Endoprosthesis and obesity. Med Arch 2013; 67(6): 446–449.

7. Guenther D et al. Overweight and obesity in hip and knee arthroplasty: Evaluation of 6078 cases. World J Orthop 2015; 6(1): 137–144.

8. Houdek MT, Wagner ER, Watts CD et al. Morbid obesity: a significant risk factor for failure of two-stage revision total hip arthroplasty for infection. J Bone Joint Surg Am 2015; 97(4): 326–332.