Kiekebos, G. (Gwende) (2013) Knieprothese loslatingenZijn er verschillen in patiënt-gerelateerde factoren van patiënten met een aseptische dan wel een septische knieprothese loslating? thesis, Medicine.
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Abstract
Background: A Total Knee Arthroplasty (TKA) is a surgery in which the knee joint is replaced by a knee prosthesis. One of the most major complications after a TKA is a loosening of the knee prosthesis. The loosening may have a non-infectious (aseptic) or an infectious (septic) cause. There is knowledge about certain patient-related factors that increases the risk of getting an aseptic or septic knee prosthesis loosening. However, there is limited knowledge whether there are differences in patient-related factors of patients with an aseptic or a septic knee prosthesis loosening. If there is loosening of the knee prosthesis, depending on the severity of the loosening and the situation of the patient, the prosthesis will be replaced (revision TKA). A revision TKA is a heavier and major surgery than a primary TKA; the patient needs to be re-operated with all negative consequences that implies. It is proved that there are differences in physical functioning and quality of life after revision TKA because of an aseptic or a septic knee prosthesis loosening. However, the results in physical functioning and quality of life after revision TKA because of aseptic or septic loosening, vary widely. Purposes: The primary aim of this retrospective study was to investigate whether there were differences in patient-related factors in patients with an aseptic or a septic knee prosthesis loosening. The secondary aim was to investigate whether there were differences after mid-term in physical functioning and quality of life after revision TKA because of aseptic or septic knee prosthesis loosening. Patients and Methods: The patient-related factors of 61 patients with an aseptic (N=32) or a septic (N=29) loosening of the knee prosthesis between 2005 and 2012 were identified. Logistic regression analyze was used to analyze whether there were differences in patient-related factors between the patients with an aseptic or a septic knee prosthetic loosening. For the assessment of physical functioning and quality of life after revision TKA, the clinical outcome, assessed with the SF-36 and WOMAC, of 24 patients were analyzed. Thereafter, the clinical outcomes between the group of patients after revision TKA because of aseptic knee prosthesis loosening (N=14) were compared with the group of patients after revision TKA because of septic knee prosthesis loosening (N=10). Results: Preoperative anemia and diabetic mellitus were found to be significant associated with the development of a knee prosthesis loosening; preoperative anemia was associated with an increased risk of developing a septic knee prosthesis loosening (OR:15.5 95% B.I: 1.61-149.03), diabetic mellitus was associated with an increased risk of developing an aseptic knee prosthesis loosening (OR: 0.03 95% B.I: 0.002-0.56). Some (non-significant) trends also have been observed; both coronary heart diseases and hypercholesterolemia seemed to give an increased risk of an aseptic loosening of the knee prosthesis. Chronic pulmonary disease seemed to give an increased risk of a septic loosening of the knee prosthesis. In addition, there were no significant differences in the SF-36 and WOMAC after mid-term revision for patients with revision TKA because of an aseptic or a septic knee prosthesis loosening. Conclusion: Preoperative anemia showed a 15.5 times higher risk of getting a septic knee prosthesis loosening compared with an aseptic knee prosthesis loosening. Diabetes mellitus showed a 33.6 times higher risk of getting an aseptic knee prosthesis loosing compared with a septic knee prosthesis loosening. In addition, there was no significant difference after mid-term in physical functioning and quality of life after revision TKA between patients with an aseptic and a septic loosening of the knee prosthesis.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Reininga, Dr. I.H.F. and Martini Ziekenhuis |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:47 |
| Last Modified: | 25 Jun 2020 10:47 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/880 |
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