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- 2018
OSOBITOSTI UGRADNJE ENDOPROTEZA KUKA I KOLJENA KOD BOLESNIKA S REUMATOIDNIM ARTRITISOMKeywords: Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disease. Despite treatment, destruction of joints develops over time. Approximately 25% of all patients with RA are required to have total joint arthroplasty during their lifetime. Th e need for operative treatment occurs when conservative therapy cannot control the underlying disease. The goal of surgical treatment is pain control and restoration of function of the affected joint. In addition to the standard preoperative preparation, attention should also be paid to the condition of the cervical spine, possible cardiovascular disease, and drugs used in the therapy of the underlying disease. In total hip replacement procedures very good results are achieved by uncemented and cemented endoprosthesis, while in the knee cemented endoprosthesis is almost exclusively used. Complications still occur more oft en than in patients with primary osteoarthritis. Periprosthetic joint infection is a serious complication occurring in about 1-3% of all cases. Implantation of a total endoprosthesis is a safe and reliable method of pain control and functional recovery in patients with RA. Abstract: Sa？etak Reumatoidni artritis (RA) kroni？na je, progresivna autoimunosna bolest. Usprkos lije？enju tijekom vremena razvija se o？te？enje zglobova. U otprilike 25% bolesnika s RA tijekom ？ivota potrebna je ugradnja totalne endoproteze (TEP). Potreba za operacijskim lije？enjem u obliku ugradnje TEP-a nastupa kad medikamentna terapija vi？e ne mo？e kontrolirati osnovnu bolest. Cilj kirur？kog lije？enja jesu kontrola boli i restauracija funkcije o？te？enog zgloba. Osim standardne prijeoperacijske obrade, valja obratiti pozornost i na stanje cervikalne kralje？nice, eventualne kardiovaskularne popratne bolesti te na medikamentnu terapiju kojom se kontrolira osnovna bolest. Pri ugradnji TEP-a kuka vrlo dobri rezultati posti？u se i primjenom cementnih i bescementnih endoproteza, dok se za koljeno primjenjuju gotovo samo cementne endoproteze. Pri ugradnji totalnih endoproteza komplikacije se jo？ i nadalje javljaju ne？to ？e？？e nego kod primarnih osteoartritisa. Periproteti？ka infekcija te？ka je komplikacija koja se javlja u 1 – 3% slu？ajeva. Ugradnja totalnih endoproteza sigurna je i pouzdana metoda kontrole boli i funkcionalnog oporavka kod bolesnika s RA
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