RESUMO
Forty-two patients older than 80 years were treated with hip arthroplasty from 1980 to 1986. Seventy-five percent experienced a complication. The most common complications were excessive bleeding, postoperative confusion, urinary tract infection, and dislocation. Hospital stay averaged 16 days and was more prolonged in 14 patients. There was one postoperative death. The survival time of the other 41 patients currently ranges from nine months to eight years. At this time, 50% are alive and functional at an average of five-years follow-up evaluation. Comparing the cost of hip arthroplasty to the cost of nursing home placement, the procedure is clearly cost effective.
Assuntos
Prótese de Quadril , Complicações Pós-Operatórias/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Seguimentos , Prótese de Quadril/economia , Prótese de Quadril/mortalidade , Humanos , Tempo de Internação , Morbidade , Complicações Pós-Operatórias/mortalidade , Qualidade de Vida , Taxa de SobrevidaRESUMO
Total hip arthroplasty, for both primary and revision operations, frequently involves bony abnormalities of the acetabulum. No standard nomenclature currently exists for the definition of acetabular deficiencies. A classification system is presented to assist in the preoperative evaluation and to provide a treatment protocol for these defects.
Assuntos
Acetábulo/cirurgia , Prótese de Quadril , Acetábulo/diagnóstico por imagem , Adulto , Doenças Ósseas/classificação , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
A 77-year-old patient had a mycotic aneurysm of the left external iliac artery secondary to migration of a total hip prosthesis. Symptoms included pain, numbness, decreased hip motion, and a temperature of 38.5 degrees. The left leg was shortened, externally rotated, and swollen. There was anterior thigh hypoesthesia and quadriceps paralysis. A pulsatile mass in the lower left quadrant of the abdomen emitted a thrill and a loud bruit. A preoperative arteriogram facilitated diagnosis and planning of surgery. A transpubic femorofemoral bypass graft was used to reroute blood to the left lower limb, avoiding vascular reconstruction in the area of the aneurysm, a suspected site of infection. A false aneurysm was determined and was then isolated. The prosthesis was removed. During this operation, the acetabular component was found freely mobile within the false aneurysm. Cultures of the removed vascular tissue grew Staphylococcus epidermidis. An arteriogram should be obtained prior to operation for any medial intrapelvic displacement of a total hip prosthesis to diagnose the extent of vascular involvement. Physical examination may not reveal the aneurysm, but signs of neuropathy or venous thrombosis may suggest this diagnosis.
