Analysis of the course of treatment of patients with corticosis using endoprosthesis in the context of the need to personalize the rehabilitation process

Abstract

Introduction. Total hip replacement is a common and succesful treatment of the osteoarthritis of the hip. Material and Methods. During the work on this article, an analysis of scientific articles on corticosis and hip arthroplasty has been made, with particular emphasis on studies investigating the influence of age and body weight on the obtained results of treatment. The second method of collecting research material was the analysis of medical records of patients operated on in Independent Public University Hospital 4 in Lublin. The analysis included 150 patients undergoing total hip replacement surgery at the Independent Public Clinical Hospital No. 4 in Lublin in 2017. Among the respondents there were 54% (n = 81) men and 46% (n = 69) women. The most common diagnosis was primary cortherapy (M16)-68.7% (n = 103), followed by other primary cortherosters (M16.1)-14.7% (n = 22), other post-traumatic cortherapy and other secondary bilateral cortherapy (M16. 5 and M16.6)-after 3.3% (n = 5), another secondary cortherapy (M16.7)-2.7% (n = 4). Other diagnoses included cases of bilateral corticosis resulting from dysplasia (M16.2), other dysplastic coxartrosis (M16.3), unspecified coxartosis (M16.9) and congenital hip deformity (Q65.0). During 90.7% (n = 136), post-lateral access was used, in 8% (n = 12) anterolateral access was used, back and front access was used in 1 case (0.7%). Results. The average length of the procedure in the study group was 55 minutes (± 23 min), the minimum duration was 30 minutes and the maximum duration was 150 minutes. Among the respondents there were 4% (n = 6) operated in the early adulthood (18-34 years), 8.7% (n = 13) in middle adulthood (35-49 years), and later in adulthood (50-64 years) there were 36% (n = 54) of the subjects, in the elderly (65-74 years) there were 28% (n = 42), and in senile age (75-89) was 23.3% (n = 35). Among the respondents, there were 77 people aged over 65 years, which is 51.3%. The obtained results coincides with the data obtained in the report commissioned by the Ministry of Health, according to which in 2015 the most operational interventions were performed among patients aged 60-69 and 70-79, which accounted for 58% of all endoprosthetic surgery. Conclusions. Based on the analysis of research literature, older age, overweight and obesity as well as diabetes are factors that significantly affect the pre-operative and post-operative rehabilitation process in the case of arthroplasty. At the same time, there is a growing tendency to personalize the improvement process, which is associated with the need to improve the quality of life of patients undergoing surgery. In the case of people over 65 years of age and obese people, it is indicated not only for a specific post-operative approach, but also for a high value of preoperative improvement. The work done in the form of re-education and improvement of the gait function and increased mobility of the hip joint pays a faster return to the peak of functional efficiency after the procedure. In the case of diabetes...