COMPLICATIONS ASSOCIATED WITH EARLY REHABILITATION OF PATIENTS AFTER TOTAL HIP AND KNEE ARTHROPLASTIES

Cilj našeg istraživanja je bio utvrditi i prikazati učestalost te vrstu komplikacija nakon ugradnje totalnih endoproteza (TEP) kuka i TEP-a koljena, u periodu rane rehabilitacije, koja je započela 8 – 10 dana nakon ugradnje TEP-a kuka ili koljena te ustanoviti postoje li statistički značajne razlike u pojavnosti komplikacija, u te dvije skupine bolesnika. U istraživanje je bio uključen 371 bolesnik: 230 bolesnika s ugrađenim TEPom kuka te 141 bolesnik s ugrađenim TEP-om koljena, praćenih u periodu od 24 mjeseca. U skupini bolesnika s ugrađenim TEP-om kuka, 66 (28,7 %) ih je bilo muškog spola, a 164 (71,3 %) ženskog spola, prosječne životne dobi od 71 godine. Kod skupine s ugrađenim TEP-om koljena, 42 (29,8 %) je bilo muškog, a 99 (70,2 %) ženskog spola, prosječne životne dobi od 71 godine. Kao najčešća komplikacija u fazi rane rehabilitacije praćenih bolesnika nakon ugradnje TEP-a kuka bila je uroinfekcija, koja se manifestirala kod 45 bolesnika (19,6 %). Kao najčešća komplikacija u fazi rane rehabilitacije praćenih bolesnika nakon ugradnje TEP-a koljena bila je uroinfekcija, koja se manifestirala kod 18 bolesnika (12,7 %). Na osnovi ovog istraživanja, nije se pokazalo da postoje statistički značajne razlike između skupina bolesnika s ugrađenim TEP-om kuka odnosno koljena, prema učestalosti ukupnih komplikacija, tijekom rane rehabilitacije ovih bolesnika. Najčešće pojedinačne komplikacije su bile uroinfekcije, u obje skupine bolesnika. Pronađena je statistički značajna razlika u učestalosti lokalnih upalnih zbivanja, s većom učestalošću u skupini s ugrađenim TEPom koljena (p = 0,000003) te statistički značajno veća učestalost nastanka dekubitalnih ulkusa u skupini s ugrađenim TEP-om kuka (p = 0,047). Rana rehabilitacija učinkovita je i potrebna mjera liječenja nakon ugradnje TEP-a kuka i koljena, a tijekom tog perioda nužno je voditi računa i o mogućim komplikacijama te posebnu pažnju posvetiti prevenciji istih.The main objective of this study was to determine the rate of complications during early rehabilitation started on postoperative days 8-10, after total hip and knee arthroplasties, as well as to determine any difference between the rate of complications in the two groups. This study included 371 patients in total: 230 patients with total hip replacement and 141 patients with total knee replacement, with 24-month follow-up period. The group of patients with total hip replacement consisted of 66 (28,7 %) male and 164 (71,3 %) female patients, with mean age of 71 years. The group of patients with total knee replacement consisted of 42 (29,8 %) male and 99 (70,2 %) female patients, also with mean age of 71 years. Complication with the highest incidence in the early rehabilitation period in the total hip replacement group was urinary tract infection (UTI), recorded in 45 patients (19,6 %). Complication with the highest incidence in the early rehabilitation period in the total knee replacement group was also urinary tract infection (UTI), recorded in 18 patients (12,7 %). This study found no significant difference between the overall rate of complications in the two groups of patients during the early rehabilitation period. The most commonly recorded complication was urinary tract infection (UTI) in both groups. Significant difference was found in local inflammatory process rates (p = 0,000003), with higher incidence in group with total knee arthroplasty. Significant difference was also found by comparing rates of new pressure ulcers recorded in two groups (p = 0,047), with higher incidence in the group with total hip arthroplasty. Early rehabilitation is an effective and necessary treatment measure following total hip and knee arthroplasties, and possible complications during early rehabilitation should be anticipated and prevented