Obesity Is Associated With Increased Complications After Operative Management of End-Stage Ankle Arthritis

Werner, Brian C.; Burrus, M. Tyrrell; Looney, Austin M.; Park, Joseph S.; Perumal, Venkat; Cooper, Minton Truitt

doi:10.1177/1071100715576569

Cited by 53 publications

(53 citation statements)

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“…126,[128][129][130][131][132][133][134] The already high risk for VTE is further exacerbated with progressively higher BMI, prolonged surgical time, older age, male sex, history of OSA, obesity hypoventilation syndrome and a previous history of VTE. 129;134,135 According to the 2013 Clinical Practice guidelines for bariatric surgical patients, it is recommended that VTE prophylaxis, including sequential compression devices and chemoprophylaxis, to be administered perioperatively.…”

Section: Venous Thromboebolismmentioning

confidence: 99%

“…Interrogation of the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database showed that in total joint arthroplasty, a BMI > 40 kg/m 2 is an independent predictor for superficial infection. 181 Similarly, obese patients undergoing open reduction and internal fixation of distal humeral fractures or total elbow arthroplasty 132 total ankle arthroplasty or ankle arthrodesis, 131 total shoulder arthroplasty 133 fixation for intertrochanteric femur fractures, 182 and fixation of a fracture of an ankle 183 all have an increased incidence of surgical-site infections when compared to non-obese patients undergoing the same surgery.…”

Section: Wound Infectionmentioning

confidence: 99%

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Perioperative management of the obese surgical patient

Lang

Parekh

Tsui

et al. 2017

British Medical Bulletin

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Section: Venous Thromboebolismmentioning

confidence: 99%

Section: Wound Infectionmentioning

confidence: 99%

Perioperative management of the obese surgical patient

Lang

Parekh

Tsui

et al. 2017

British Medical Bulletin

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“…Obesity is recognized as an independent risk factor for perioperative venous thromboembolism (VTE) [29][30][31][32][33][34]. Recent ACS-NSQIP database analysis finds that a BMI at least 40 kg/m 2 significantly increased the odds of VTE after CABG, total hip arthroplasty, colectomy, prostatectomy, and pancreatectomy [6 && ].…”

Section: Thromboembolic Complicationsmentioning

confidence: 99%

“…These complications include longer operative times [38][39][40], possibly increased blood loss [38,40], increased rates of reintervention [5,34,36], and increased rates of infection [5,6 && , [32][33][34]36,40]. Analysis of various general surgery patients has shown a significant direct correlation between increasing BMI and increased intraoperative blood loss [38,40].…”

Section: Surgical Complicationsmentioning

confidence: 99%

Morbid obesity and perioperative complications

Tsai

Schumann

2016

Current Opinion in Anaesthesiology

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“…Some authors report unsatisfactory outcomes of arthrodesis in patients suffering from obesity, diabetes mellitus, rheumatoid arthritis, impaired blood supply of the distal part of the lower limb [39][40][41][42].…”

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confidence: 99%

The Concept of Modern Ankle Joint Arthrodesis in Posttraumatic Crusarthrosis, Grade III–IV

Gorbatov¹,

Горін²,

Павлов³

2016

Sovrem Tehnol Med

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The aim of the investigation was to work out a concept of modern arthrodesis of the ankle joint in posttraumatic crusarthrosis, grade III-IV, using innovative fixing implants.Materials and Methods. The results of treating 53 patients covering the period from 1 to 15 years after 56 operations of arthrodesis, performed for posttraumatic crusarthrosis, grade III-IV (according to Kellgren and Lawrence classification), have been analyzes. The conclusions were based on the data of radiographic, clinical examination and the scoring according to the international rating scale AOFAS. Arthrodesis was performed using state-of-the-art fixing implants: with the help of the screws, retrograde intramedullary HAN rod, Ilizarov apparatus for external fixation, wires.Results. In the majority of patients (41%) the main cause of developing posttraumatic crusarthrosis of grade III-IV was unrepaired intraarticular dislocation of the ankle fragments and a large fragment (more than 1/3) of the posterior tibia margin. The best results, i.e. fewer ligamentous ankylosis (32%) and the greatest number of good (39%) and satisfied (54%) results according to AOFAS scale were obtained when crossed screws were used in arthrodesis. It was estimated, that the assessment of clinical and functional signs according to the international scale AOFAS does not reflects the most vital spectrum of life activity indices of patients, therefore, it has been suggested to use additionally individualized indices characterizing the quality of life of patients of various professions, levels of every-day activity and psychological motivation to adequate rehabilitation. Unsatisfied radiographic findings did not always corresponded to the poor clinical results. In 56% of patients with ligamentous ankylosis the result according to AOFAS was good or satisfactory (slight pains in prolonged walking, moving without additional supporting means, absence of evident limping).Conclusion. The worked out concept of modern arthrodesis is as follows: 1) the choice of ankle arthrodesis method and the type of a fixing implant must depend not only on the type of deformation, but on the patient's age, gender traits, diseases contributing to the development of unfavorable treatment results; 2) the best clinical and functional results are connected with the method of fixation providing primary stability, and with regenerative and adaptive capabilities of patients in diverse age groups; 3) the most optimal state-of-the-art implants for arthrodesis are crossed screws for fixation, providing the greatest strength and good primary compression, if there is no marked disorder of blood supply of the articular bones and radical removal of the cartilaginous tissue.

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Obesity Is Associated With Increased Complications After Operative Management of End-Stage Ankle Arthritis

Abstract: Level III, comparative series.

Cited by 53 publications

References 54 publications

Perioperative management of the obese surgical patient

Perioperative management of the obese surgical patient

Morbid obesity and perioperative complications

The Concept of Modern Ankle Joint Arthrodesis in Posttraumatic Crusarthrosis, Grade III–IV

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