Perioperational management of elderly and senile patients based on a comprehensive geriatric assessment for endoprosthetics of large joint

Abstract

Introduction. Due to the changing age structure of the world’s population, an increase in the number of geriatric patients undergoing endoprosthetics of large joints is to be expected in the future. Age-related frailty and existing comorbidities pose problems for the entire treatment team.The aim of the study was to determine the effectiveness of comprehensive geriatric management of elderly and senile patients before and after endoprosthetic of the hip and knee joints.Materials and methods. An analysis of publications on the use of comprehensive in endoprosthetic of large joints in elderly and senile patients with osteoarthritis was performed. Searched in the electronic databases and libraries Web of Science, Conchrane library, PubMed, eLibrary using the search words: comprehensive geriatric assessment.Results and discussion. There is an increasing incidence of large joints endoprosthetic in orthogeriatric patients with osteoarthritis. Anaesthesia and arthroplasty in this group of patients is an important issue, as well as ensuring immediate postoperative mobilization of the patient. An individualized patient preparation plan for surgical intervention and postoperative management, aimed at preventing the development of transient cognitive impairment and other complications associated with geriatric status, in particular falls, is a necessary organizational element of treatment.Conclusion. A comprehensive geriatric assessment plays a crucial role in the perioperative introduction of geriatric patients for endoprosthetic of large joints. Timely identification of geriatric patients during the preoperative phase eliminates risk factors.