Reus, I. (2013) De relatie tussen patiëntgerelateerde factoren en (a)septische loslating van een heupprothese. thesis, Medicine.
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Abstract
Introduction: Total hip arthroplasty (THA) is a commonly used surgical treatment of osteoarthritis of the hip joint. A frequent complication of THA is loosening of one or both components of the prosthesis. Loosening of the hip prosthesis is usually caused by mechanical (aseptic) causes but can also have an infectional (septic) cause. Both types of loosening of the hip prosthesis require a different surgical treatment. The treatment of aseptic loosening of the hip prosthesis consists of one operation during which one or both components of the prosthesis are being changed (1-stage revision THA). Treatment of septic loosening of the hip prosthesis requires a more intensive treatment because first the infection has to be cleared. Previous studies showed that certain patient-related factors have an increased risk of aseptic or septic loosening of the hip prosthesis. However, no study has been performed into the difference between patient-related factors with aseptic or septic loosening of the hip prosthesis. The aim of this study was to identify patient-related factors that are associated with an increased risk of aseptic or septic loosening of the hip prosthesis. Methods: This retrospective cohort study consisted of 257 patients who underwent a revision THA between 1 January 2007 and 31 December 2011 admitted to the orthopedic unit of the Martini Hospital in Groningen. After in- and exclusioncriteria, 161 patients were being included. Patient-related and surgical factors were derived from EPD and patient charts. Analysed patient-related factors included the 19 specific diseases that are used to determine the Charlson Comorbidity Index as well as the 30 most common chronic diseases according to the Dutch Institute for Public Health and the Environment (RIVM). Uni- and multivariate logistic regressions were performed to identify patient-related factors related to aseptic or septic loosening of the hip prosthesis. Results: Of the 161 patients, 151 patients had an aseptic loosening and 15 patients had a septic loosening of the hip prosthesis. Analysis showed that myocardial infarction (OR, 7.37; BI 1.86-29.20) and cancer (OR, 5.25; BI 1.65-16.76) had a raised chance for septic loosening in comparison with aseptic loosening of the hip prosthesis. Overweight showed to be a raised chance OR, 0.26; BI, 0.07-0.97) for aseptic loosening of the hip prosthesis. Also having a high Charlson score (> 5) in comparison with a Charlson score of 0 was a risk factor for septic loosening of the hip prosthesis. Conclusions: This study showed that patients with myocardial infarction or cancer in the medical history have a significant higher risk for septic loosening in comparison with aseptic loosening of the hip prosthesis. Overweight is a risk factor for aseptic loosening in comparison with septic loosening of the hip prosthesis. Also having a high Charlson score (> 5) is a risk factor for septic loosening of the hip 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/811 |
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