Preoperative Patient Optimization for Lower Extremity Total Joint Arthroplasty Surgery.

IF 2.4 Q2 SURGERY
JBJS Reviews Pub Date : 2025-06-20 eCollection Date: 2025-06-01 DOI:10.2106/JBJS.RVW.25.00037
Kristen Barton, Jason M Jennings, Douglas A Dennis, Antonia F Chen
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引用次数: 0

Abstract

» Identifying medical comorbidities and optimizing modifiable risk factors (biological, social, and psychological) have been suggested as a strategy to improve the value of total joint arthroplasty (TJA) care, while reducing the risk of intraoperative and postoperative complications. Modifiable biological factors include weight management to reduce obesity, optimizing diabetic control, improving malnutrition, optimizing bone health, improving anemia, managing anticoagulants and bleeding risk, controlling inflammatory conditions, reducing methicillin-sensitive Staphylococcus aureus/methicillin-resistant S. aureus colonization, and reducing frailty. Modifiable social and psychological factors include tobacco and smoking cessation, reducing alcohol use, ceasing drug use/misuse, optimizing mental health (i.e., depression, anxiety), patient TJA education and managing expectations, and evaluating discharge determination and living status. This review comprehensively evaluates and summarizes preoperative patient optimization strategies for lower extremity TJA surgery, both in the primary and revision settings.

下肢全关节置换术术前患者优化。
»识别医学合并症和优化可改变的危险因素(生物、社会和心理)已被建议作为提高全关节置换术(TJA)护理价值的策略,同时降低术中和术后并发症的风险。可改变的生物因素包括体重管理以减少肥胖、优化糖尿病控制、改善营养不良、优化骨骼健康、改善贫血、管理抗凝血和出血风险、控制炎症、减少对甲氧西林敏感的金黄色葡萄球菌/耐甲氧西林的金黄色葡萄球菌定植以及减少虚弱。可改变的社会和心理因素包括戒烟、减少酒精使用、停止药物使用/滥用、优化心理健康(即抑郁、焦虑)、患者TJA教育和管理期望,以及评估出院决定和生活状况。这篇综述全面评估和总结了下肢TJA手术的术前患者优化策略,包括原发性和翻修性。
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来源期刊
JBJS Reviews
JBJS Reviews SURGERY-
CiteScore
4.40
自引率
4.30%
发文量
132
期刊介绍: JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.
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