Total hip and knee arthoplasty: on the issue of indications for surgery

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Abstract

Background. Both in Russia and across the world, the annual frequency of total hip and knee replacement has increased, which has inevitably led to an increase in the number of patients with unsatisfactory treatment outcomes. This failure can primarily be attributed to the complications that arise, some of which arise due to the wrong choice of treatment approach.

Aim. To analyze the publications on the results of treatment of patients with hip osteoarthritis and knee osteoarthritis by total hip and knee replacements.

Materials and methods. The literature data were searched in open electronic databases of scientific literature PubMed and eLibrary using the following keywords and phrases: total hip/knee replacement, complications, patient satisfaction, age, obesity. The search depth was 20 years.

Results. The data indicated a rise in the total number of such patients recorded annually. A significant number of publications, both in Russian and foreign literature, are devoted to the analysis of complications that mainly determine the patient’s satisfaction with an operation. In addition, these articles analyze the issues of determining the indications and contraindications in applying these methods of treatment. However, it is not uncommon for orthopedists to form a decision for performing an operation based on their subjective experience. At the same time, one of the circumstances that influences the decision-making is the lack of a stable system in the conservative treatment of degenerative joint diseases. According to the data from health care organizations, hip and knee replacements are the only available method for treating osteoarthritis. This circumstance may lead to an unjustified expansion of indications for arthroplasty, which would definitely affect the outcomes of treatment. In this situation, it is critical to search for precise criteria to identify the indication for total hip and knee arthroplasty.

Conclusion. Unjustified expansion of indications for endoprosthesis leads to an increase in the number of complications, which in turn leads to an increase in the number of patients who remain unsatisfied with the outcomes of hip and knee arthroplasty in the long term. This circumstance encourages special scientific research to clarify the indications and contraindications for hip and knee replacements, especially in young and middle-aged people.

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About the authors

Alim A. Vorokov

North-Western State Medical University named after I.I. Mechnikov

Email: alimbekvor@icloud.com

MD, resident of the Clinic of Traumatology and Orthopedics

Russian Federation, Saint Petersburg

Pavel I. Bortulev

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: pavel.bortulev@yandex.ru
ORCID iD: 0000-0003-4931-2817

MD, Research Associate of the Department of Hip Pathology

Russian Federation, Saint Petersburg

Valery M. Khaydarov

North-Western State Medical University named after I.I. Mechnikov

Email: drxaidarov@mail.ru
ORCID iD: 0000-0002-0754-4348

MD, PhD, Assistant of the Department of Traumotology and Orthopedic

Russian Federation, Saint Petersburg

Stanislav A. Linnik

North-Western State Medical University named after I.I. Mechnikov

Email: stanislavlinnik@mail.ru
ORCID iD: 0000-0002-4840-6662

MD, PhD, D.Sc., Professor of the Department of Traumotology and Orthopedic, Military Field Surgery

Russian Federation, Saint Petersburg

Aleksandr N. Tkachenko

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: altkachenko@mail.ru
ORCID iD: 0000-0003-4585-5160

MD, PhD, D.Sc., Professor of the Department of Traumotology and Orthopedic, Military Field Surgery

Russian Federation, Saint Petersburg

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Copyright (c) 2020 Vorokov A.A., Bortulev P.I., Khaydarov V.M., Linnik S.A., Tkachenko A.N.

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