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2015 | OriginalPaper | Buchkapitel

11. Postoperative Komplikationen

verfasst von : Jörg Jerosch, Prof. Dr. med. Dr. h. c.

Erschienen in: Knieendoprothetik

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die Operation zum Totalersatz eines Kniegelenkes stellt erst den Anfang in der Behandlung der zugrundeliegenden Kniegelenkerkrankung dar. Zur dauerhaften Sicherstellung des Erfolgs müssen gefährdende Komplikationen vermieden werden. Adäquate Wundversorgung, postoperative Analgesie, Verhütung einer tiefen Venenthrombose, postoperative Transfusionen und die Sicherung eines ausreichenden Bewegungsumfanges sind wichtige Fragen der Betreuung. Dieses Kapitel behandelt die Prävention von Komplikationen in der postoperativen Phase nach einem kniealloarthroplastischen Eingriff und die Probleme der postoperativen Schmerzkontrolle, des Blutverlustes, der Wundversorgung sowie der Mobilisierung. Allgemeines Ziel der postoperativen Behandlung eines Endoprothesenträgers ist es, Komplikationen weitgehend zu vermeiden und eine Rückkehr des Patienten zu einer allgemeinen Gesundheit mit der frühest- und bestmöglichen Funktion des ersetzten Kniegelenkes zu erreichen.
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Zurück zum Zitat Springer BD, Della Valle CJ (2008) Extensor mechanism allograft reconstruction after total knee arthroplasty. J Arthroplasty 23(7 Suppl 7):35–38PubMed Springer BD, Della Valle CJ (2008) Extensor mechanism allograft reconstruction after total knee arthroplasty. J Arthroplasty 23(7 Suppl 7):35–38PubMed
Zurück zum Zitat Springer HH, Jäger M (1981) Femurfrakturen nach Hüft- und Kniegelenksendoprothesen beim alten Menschen - Ursachen und Therapiemöglichkeiten. Orthop Praxis 17:366 Springer HH, Jäger M (1981) Femurfrakturen nach Hüft- und Kniegelenksendoprothesen beim alten Menschen - Ursachen und Therapiemöglichkeiten. Orthop Praxis 17:366
Zurück zum Zitat Stinchfield FE, Bigliani LV, Neu HC, Goss TP, Foster CR (1980) Late hematogenous infections of total joint replacement. J Bone Joint Surg 62 A:1345–1350 Stinchfield FE, Bigliani LV, Neu HC, Goss TP, Foster CR (1980) Late hematogenous infections of total joint replacement. J Bone Joint Surg 62 A:1345–1350
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Zurück zum Zitat Tria AJ jr, Harwood DA, Alicea JA, Cody RP (1994) Patellar fractures in posterior stabilized knee arthroplasties. Clin Orthop 299: 131-138 Tria AJ jr, Harwood DA, Alicea JA, Cody RP (1994) Patellar fractures in posterior stabilized knee arthroplasties. Clin Orthop 299: 131-138
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Zurück zum Zitat Von Jonbergen HPW, Scholtes VAB, Poolman RW (2014) A randomised, controlled trial of circumpatellar elctrocautery in total knee replacement without patellar resurfacing. Bone Joint J 96-B:473–478PubMed Von Jonbergen HPW, Scholtes VAB, Poolman RW (2014) A randomised, controlled trial of circumpatellar elctrocautery in total knee replacement without patellar resurfacing. Bone Joint J 96-B:473–478PubMed
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Zurück zum Zitat Walker RH, Schurman DJ (1984) Management of infected total knee arthroplasties. Clin Orthop 186:81–89PubMed Walker RH, Schurman DJ (1984) Management of infected total knee arthroplasties. Clin Orthop 186:81–89PubMed
Zurück zum Zitat Wang JH, Zhao JZ, He YH (2007) A new treatment strategy for server arthrofibrosis of the knee: Surgical technique. J Bone Joint Surg Am 89(supp 2, pt 1):93–102PubMed Wang JH, Zhao JZ, He YH (2007) A new treatment strategy for server arthrofibrosis of the knee: Surgical technique. J Bone Joint Surg Am 89(supp 2, pt 1):93–102PubMed
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Zurück zum Zitat Wasilewski SA, Frankl U (1989b) Fracture of polyethylene of patellar component in total knee arthroplasty, diagnosed by arthroscopy. J Arthroplasty 4(Suppl):SI9–S22 Wasilewski SA, Frankl U (1989b) Fracture of polyethylene of patellar component in total knee arthroplasty, diagnosed by arthroscopy. J Arthroplasty 4(Suppl):SI9–S22
Zurück zum Zitat Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH (2002) Have we found an ideal soft tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 109(7):2219–2226 (discussion 2227-2230)PubMed Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH (2002) Have we found an ideal soft tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 109(7):2219–2226 (discussion 2227-2230)PubMed
Zurück zum Zitat Weiss AP, Krackow KA (1993) Persistent wound drainage after primary total knee arthroplasty. J Arthroplasty 8(3):285–289PubMed Weiss AP, Krackow KA (1993) Persistent wound drainage after primary total knee arthroplasty. J Arthroplasty 8(3):285–289PubMed
Zurück zum Zitat Weissman BN, Scott RD, Brick GW, Corson JM (1991) Radiographic detection of metal-induced synovitis as a complication of total arthroplasty of the knee. J Bone Joint Surg 73(7):1002–1007PubMed Weissman BN, Scott RD, Brick GW, Corson JM (1991) Radiographic detection of metal-induced synovitis as a complication of total arthroplasty of the knee. J Bone Joint Surg 73(7):1002–1007PubMed
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Zurück zum Zitat Whiteside LA (2004) Ligament balancing in revision total knee arthroplasty. Clin Orthop Relat Res 23(423):178–185 Whiteside LA (2004) Ligament balancing in revision total knee arthroplasty. Clin Orthop Relat Res 23(423):178–185
Zurück zum Zitat Wilde AH, Ruth JJ (1988) Two-stage reimplantation in infected total knee arthroplasty. Clin Orthop 236:23–35PubMed Wilde AH, Ruth JJ (1988) Two-stage reimplantation in infected total knee arthroplasty. Clin Orthop 236:23–35PubMed
Zurück zum Zitat Wilde AH, Stearns KL (1989) Intramedullary fixation for arthrodesis of the knee after infected total knee arthroplasty. Clin Orthop 248:87–92PubMed Wilde AH, Stearns KL (1989) Intramedullary fixation for arthrodesis of the knee after infected total knee arthroplasty. Clin Orthop 248:87–92PubMed
Zurück zum Zitat Wilde AH, Sweeney RS, Borden LS (1988) Hematogenously acquired infection of a total knee arthroplasty by clostridium perfringens. Clin Orthop 229:228–231PubMed Wilde AH, Sweeney RS, Borden LS (1988) Hematogenously acquired infection of a total knee arthroplasty by clostridium perfringens. Clin Orthop 229:228–231PubMed
Zurück zum Zitat Wilson MG, Kelley K, Thornhill TS (1990) Infection as a complication total knee arthroplasty. J Bone Joint Surg 72 A:878–883 Wilson MG, Kelley K, Thornhill TS (1990) Infection as a complication total knee arthroplasty. J Bone Joint Surg 72 A:878–883
Zurück zum Zitat Windsor RE, Scuderi GR, Moran MC, Insall JN (1989) Mechanisms of failure of femoral and tibial components in total knee arthroplasty. Clin Orthop 248:15–20PubMed Windsor RE, Scuderi GR, Moran MC, Insall JN (1989) Mechanisms of failure of femoral and tibial components in total knee arthroplasty. Clin Orthop 248:15–20PubMed
Zurück zum Zitat Windsor RE, Insall JN, Urs WK, Miller DV, Brause B (1990) Twostage reimplantation for the salvage of total knee arthroplasty complicated by infection. J Bone Joint Surg 72 A:272–278 Windsor RE, Insall JN, Urs WK, Miller DV, Brause B (1990) Twostage reimplantation for the salvage of total knee arthroplasty complicated by infection. J Bone Joint Surg 72 A:272–278
Zurück zum Zitat Wong RY, Lotke PA, Ecker ML (1986) Factors influencing wound healing after total knee arthroplasty. Orthop Trans 10:497 Wong RY, Lotke PA, Ecker ML (1986) Factors influencing wound healing after total knee arthroplasty. Orthop Trans 10:497
Zurück zum Zitat Woods GW, Lionberger DR, Tullos HS (1983) Failed total knee arthroplasty. Revision and arthrodesis for infected and noninfectious complications. Clin Orthop 173:184–190PubMed Woods GW, Lionberger DR, Tullos HS (1983) Failed total knee arthroplasty. Revision and arthrodesis for infected and noninfectious complications. Clin Orthop 173:184–190PubMed
Zurück zum Zitat Woolsen ST, Watt M (1991) Use of autologous blood in total hip replacement: a comprehensive program. J Bone Joint Surg 73 A:76–80 Woolsen ST, Watt M (1991) Use of autologous blood in total hip replacement: a comprehensive program. J Bone Joint Surg 73 A:76–80
Zurück zum Zitat Wright TM, Bartel DL (1986) The problem of surface damage in polyethylene total knee components. Clin Orthop 205:67–74PubMed Wright TM, Bartel DL (1986) The problem of surface damage in polyethylene total knee components. Clin Orthop 205:67–74PubMed
Zurück zum Zitat Wülker N, Böhm S (1994) Ergebnisse des patello-femoralen Gelenkersatzes bei verschiedenen Knie-Endoprothesen (Typ GSB und ES). Z Orthop 132:412–419PubMed Wülker N, Böhm S (1994) Ergebnisse des patello-femoralen Gelenkersatzes bei verschiedenen Knie-Endoprothesen (Typ GSB und ES). Z Orthop 132:412–419PubMed
Zurück zum Zitat Yercan HS, Sugun TS, Bussiere C, Ait Si Selmi T, Davis A, Neyret P (2006) Stiffness after total knee arthroplasty: Prevalence, management and outcomes. Knee 13(2):111–117PubMed Yercan HS, Sugun TS, Bussiere C, Ait Si Selmi T, Davis A, Neyret P (2006) Stiffness after total knee arthroplasty: Prevalence, management and outcomes. Knee 13(2):111–117PubMed
Zurück zum Zitat Yim SJ, Jang MS, Kim WJ, Lee SH, Kang HK (2012) The effect of electrocautery around the patellar rim in patellar non-resurfacing total knee arthroplasty. Knee Surg Relat Res 24:104–107PubMedCentralPubMed Yim SJ, Jang MS, Kim WJ, Lee SH, Kang HK (2012) The effect of electrocautery around the patellar rim in patellar non-resurfacing total knee arthroplasty. Knee Surg Relat Res 24:104–107PubMedCentralPubMed
Metadaten
Titel
Postoperative Komplikationen
verfasst von
Jörg Jerosch, Prof. Dr. med. Dr. h. c.
Copyright-Jahr
2015
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-642-38423-3_11

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