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DOI: https://doi.org/10.22263/2312-4156.2020.5.72

Balaboshka K.B., Khadzkou Y.K.
The possibilities of using the method of perioperative management of total knee replacement
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2020;19(5):72-79.

Abstract.
Objectives. To determine the effectiveness of the proposed integrated approach to perioperative management of primary total knee replacement (TKA), revision surgery and one-stage bilateral surgery, as well as in the presence of anemia in patients at the preoperative period.
Material and methods.The prospective study included 283 patients with stage 3 osteoarthritis of the knee joint (9 patients with anemia at the preoperative stage) who underwent TKA according to primary indications and 5 patients who underwent revision surgery for aseptic instability of endoprosthesis components. A female patient with bilateral osteoarthritis of the knee joints in whom TKA was performed simultaneously on both sides was also included in the study. In the treatment of all patients, the «method of perioperative management of knee replacement» was used. In the course of this study blood count before and after surgical intervention , the severity of pain syndrome according to the numeric rating scale for pain (NRS), and the functional result according to the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were evaluated.
Results. The introduction of a multimodal approach to reducing blood loss and pain intensity made it possible to eliminate the need for donated blood transfusion in all cases, to significantly reduce the level of pain syndrome in the early postoperative period, and to cut down the economic costs of treating patients with osteoarthritis of the knee joint.
Conclusions. An integrated approach to the perioperative management of knee replacement enables the effective reduction of perioperative blood loss and the intensity of pain during primary total knee replacement, and also creates favourable conditions for performing revision and simultaneous bilateral surgery, and when performing surgery in patients with anemia at the preoperative period.
Key words: knee replacement, blood loss, analgesia, perioperative management, rehabilitation.

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Information about authors:
Balaboshka K.B. – Candidate of Medical Sciences, associate professor, head of the Chair of Traumatology, Orthopedics & Military Surgery, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0002-5599-3439;
Khadzkou Y.K. – lecturer of the Chair of Traumatology, Orthopedics & Military Surgery, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0002-9216-7929.

Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Traumatology, Orthopedics & Military Surgery. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Yauheni K. Khadzkou.

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