SEPTIC ARTHRITIS AFTER TOTAL KNEE REPLACEMENT IN GERIATRICS PATIENT, THE IMPORTANT OF PERIOPERATIVE CARE

Kris Jaya, Devin Alexander, Louis Rianto

Abstract


Introduction: The geriatric population are the fastest growing segment around the world. The prevalence of multiple comorbidities in geriatric patients requiring special perioperative care. Perioperative management must be done properly, considering that surgical complications on geriatric can cause multiple comorbidities. There are many complications that often occur in geriatrics, one of which is infection.

Case report: A 77-year-old man complained about pain on his right knee 1 – 2 weeks after doing TKR procedure. The pain accompanied with fever, swollen, and redness. Physical examination showed elevated blood pressure (140/90), Fever (37,4oC), obesity grade I (BMI 27.4 kg/m2), swollen and redness on his right knee, pain on palpation with VAS 5, edema (+). Barthel index ADL showed mild dependency, FRAIL score 3, qSOFA score 0. Laboratory result showed elevated leukocyte 14.900/µl.

Conclusion: Geriatric patients are very vulnerable to the risks of surgery, one of which is septic arthritis. So that a good perioperative evaluation can reduce complications, comorbidities and decreased functional status

Save to Mendeley


Keywords


Perioperative procedure; geriatric; septic arthritis

Full Text:

PDF

References


Aceto, P., Incalzi, R., Bettelli, G., Car-ron, M., Chiumiento, F., Corcione, A., et al. (2020). Perioperative Manage-ment of Elderly patients (PriME): rec-ommendations from an Italian interso-ciety consensus. Aging Clinical and Experimental Research : 32(9):1647-1673. Available From : https://doi.org/10.1007/s40520-020-01624-x

Anderson, S., Brenner, B. (1987) The aging kidney: structure, function, mechanisms, and therapeutic implica-tions. J Am Geriatr Soc : 35(6):590‐593. Available From: https://doi.org/10.1111/j.1532-5415.1987.tb01407.x

AHRQ. (2013) Preventing falls in hospitals: a toolkit for improving quali-ty of care. AHRQ publication No. 13‐0015‐EF 2013; Available at: https://www.ahrq.gov/sites/default/files/publications/files/fallpxtoolkit.pdf

P. Barbosa, T., Souza, A., Leme, F., Grassi, L., Cintra, F., Lima, R et al. (2019) Perioperative complications and mortality in elderly patients following surgery for femoral fracture: prospec-tive observational study. Brazilian Journal of Anesthesiology (English Edition). 2019;69(6):569-579. Availa-ble From: http://dx.doi.org/10.1016/j.bjane.2019.10.008

Chow, W., Rosenthal, R., Merkow, R., Ko, C., Esnaola, N. (2012) American College of Surgeons National Surgical Quality Improvement Program; Amer-ican Geriatrics Society. Optimal pre-operative assessment of the geriatric surgical patient: a best practices guide-line from the American College of Surgeons National Surgical Quality Improvement Program and the Ameri-can Geriatrics Society. J Am Coll Surg : 215(4):453-66. Available From: https://doi.org/10.1016/j.jamcollsurg.2012.06.017

Fleisher,L.,Fleischmann, K., Auerbach, A.,Barnason, S., Beckman, J., Bozkurt, B.et al.(2014) 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and man-agement of patients undergoing non-cardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Asso-ciation Task Force on Practice Guide-lines. Circulation : 130(24):2215-45. Available From : https://doi.org/10.1161/CIR.0000000000000105

Fried, L., Tangen, C., Walston, J., Newman, A., Hirsch, C., Gottdiener, J. et al. (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol SciMed Sci: 56:M146–156. Available From: https://doi.org/10.1093/gerona/56.3.m146

Gould, C.,Umscheid, C., Agarwal, R., Kuntz, G., Pegues, D., and Healthcare Infection Control Practices Advisory Commitee. (2015). Guideline for pre-vention of catheter‐associated urinary tract infections 2009. Infect Control Hosp Epidemiol : 31(4):319‐326. Available From : https://doi.org/10.1086/651091

Janssens, J. (2005). Aging of the respiratory system: impact on pul-monary function tests and adaptation to exertion. Clin Chest Med 2005;26(3):469–84, vi‐vii. Available From: https://doi.org/10.1016/j.ccm.2005.05.004.

Kalore, N., Gloe, T., Singh, J. (2011). Diagnosis and Management of Infect-ed Total Knee Arthroplasty. Open Or-thop J : 5: 86 – 91. Available From : doi: 10.2174/1874325001105010086

Knittel, J., and Wildes, T. (2016). Preoperative Assessment of Geriatric Patients. Anesthesiol Clin.: 34(1):171-83. doi: 10.1016/j.anclin.2015.10.013. PMID: 26927746. Available From : https://doi.org/10.1016/j.anclin.2015.10.013

Ko, F. (2019). Preoperative Frailty Evaluation: A Promising Risk-stratification Tool in Older Adults Undergoing General Surgery. Clinical Therapeutics. : 41(3):387-399. Available From : https://doi.org/10.1016/j.clinthera.2019.01.014

Laksmi, P., Harimurti, K., Setiani, S., Soejono, C., Aries, W., Roosheroe, A. (2008). Management of Immobiliza-tion and Its Complication for Elderly. Acta Med Indones-Indones J Intern Med : 40(4): 233 – 40. Availa-ble From: https://pubmed.ncbi.nlm.nih.gov/19151453/

Mohanty, S., Rosenthal, R., Russell, M., Neuman, M., Ko, C., Esnaola, N. (2016). Optimal Perioperative Man-agement of the Geriatric Patient: A Best Practices Guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. J Am Coll Surg. 2016 May;222(5):930-47. Available From: https://doi.org/10.1016/j.jamcollsurg.2015.12.026

Olotu, C., Weimann, A., Bahrs, C., Schwenk, W., Scherer, M., Kiefmann, R. (2019) The Perioperative Care of Older Patients. Dtsch Arztebl Int.: 116(5): 63 – 9. Available from : doi: 10.3238/arztebl.2019.0063

Schlitzkus, L., Melin, A., Johanning, J., Schenarts, P. (2015). Periopera-tive Management of Elderly Pa-tients. Surgical Clinics of North America. : 95(2):391-415. Available From : https://doi.org/10.1016/j.suc.2014.12.001

Sieber, F., and Barnett, S. (2011). Preventing Postoperative Complica-tions in the Elderly. Anesthesiol Clin.: 29(1): 83 – 97. Available from : doi: 10.1016/j.anclin.2010.11.011

Wirtz, D., and Kohlhof, H. (2019). The Geriatric Patient : Special As-pects of Peri-Operative Manage-ment. EFORT Open Rev : 4(6): 240 – 7. Available from: doi: 10.1302/2058-5241.4.180087

Wolfe, J., Wolfe, N., Rich, M. (2020). Perioperative care of the ger-iatric patient for noncardiac surgery. Clin Cardiol. 2020 Feb;43(2):127-136. Available From: https://doi.org/10.1002/clc.23302




DOI: https://doi.org/10.33508/jwmj.v3i4.3508

Refbacks

  • There are currently no refbacks.