Obesity and musculoskeletal care general concepts
-
Upload
ahmed-qutub -
Category
Health & Medicine
-
view
23 -
download
0
Transcript of Obesity and musculoskeletal care general concepts
![Page 1: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/1.jpg)
Obesity and Musculoskeletal Care
AhmedAlqatub4thyearICMS
![Page 2: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/2.jpg)
Background • nega6velyaffectsorthopaedic.• 1.5Boverweight&500Mwereobese.• Overweight25-29.9• Obese30orhigher• expandingperspec6vesontreatmentop6onsandchallengesurgicalskills.
![Page 3: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/3.jpg)
• burdenofobesityissignificantonavarietyofoutcomemeasuresincluding:• infec6onrisk,• non-union,• persistentpain,• cost,andimplantfailure.
![Page 4: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/4.jpg)
Co-Morbid Condi8ons and Peri-Opera8ve Management
• diabetes,• coronaryarterydisease,• deepveinthrombosis,• pulmonaryembolus,• malignancy,• obstruc6vesleepapnea,andasthma.
![Page 5: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/5.jpg)
Individualized anesthe8c Plan
• peri-opera6veperiod,prematuredeath• Anesthe6cintuba6onwithafiber-op6c.• Regionalanesthesia.
![Page 6: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/6.jpg)
• well-paddedtablesandboards:• Pressureulcera6ons,nervepalsies,andcompartmentsyndromesmorereadilyoccurinobesethannon-obeseindividuals• Nursingcare.
![Page 7: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/7.jpg)
Total Joint Arthroplasty
• Obesityhasadirectresultonthedevelopmentofosteoarthri6softhehipandkneejoints.• TheneedforhavingaTKR• 8.5%mesBMI>30,• 18.7%mesBMI>35,• 32.76mesBMI>40.
• BMI>40appeartohaveevenhighercomplica6on.
![Page 8: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/8.jpg)
TKR
• hashigherrisksofinfec6on,• increasedbloodloss;• woundrelatedproblems,• avulsionofthemedialcollateralligament,• componentmalposi6oning,• extensormechanismrupture,• andpatellarmaltracking.
![Page 9: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/9.jpg)
• Thesecomplica6onratesalsoincreaseastheBMIincreases.• Inmedialunicompartmentalarthroplasty:• componentloosening,• failure,• andfracture.
![Page 10: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/10.jpg)
THR
• Thereappearstobeevidencethatobesityhasadirectassocia6onwith:• infec6onrates.• higherrisksforhardwaremalposi6oning,• thromboembolicevents,• higherbloodloss,• loosening,infec6on,andul6mately,catastrophicfailure.
![Page 11: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/11.jpg)
Pediatrics
• Blount'sdisease• increasedriskforgenuvalgumandrecurvatum.• Slippedcapitalfemoralepiphysis(SCFE),bilateralSCFEisseenmorecommonlyinobesechildren.• distalpartoftheextremity
![Page 12: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/12.jpg)
Spine
• low-backpain.• Lumbardiscdegenera6on.• higherriskofcomplica6onsincludinghardwarefailureandinfec6on,• newerpercutaneous,lessinvasivetreatmentsshowpromisetodiminishtheserisks.• idiopathicscoliosis,poorbracefitandwearinobeseindividuals.
![Page 13: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/13.jpg)
Shoulder and Elbow
• Rotatorcufftendoni6sandshoulderimpingement.• Aopera6ve6me,lengthofhospitaliza6on,andfunc6onaloutcomes.
• shoulderarthroplastyrequirespreciseosteotomiesandcarefulso_6ssuehandling.• Inhumeralheadreplacement,revisionsurgery• reversetotalshoulderarthroplastyhasbeenshowntohavesuccessfulclinicaloutcomes
![Page 14: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/14.jpg)
Foot and Ankle
• Achillestendoni6s,• plantarfascii6s,• andposterior6bialtendondysfunc6on.
![Page 15: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/15.jpg)
Hand
• Carpaltunnelsyndrome• Mul6pletriggerfingers• decreaseinhandgripstrength.
![Page 16: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/16.jpg)
Sports and Arthroscopy
• Meniscaltearsandrotatorcufftendoni6s• ACLRECONpost-trauma6costeoarthri6s.• lossofsuperficiallandmarks
![Page 17: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/17.jpg)
Trauma
• é distalfemur,ankle,calcaneusandinternaldeglovinginjuries.• spontaneouskneedisloca6ons• Obeseelderly,extra-capsularproximalfemur• missedproximalfemurfracture• obesityisarela6veindica6onforretrogradenailfixationorantegradenailfixa6on• Mul6plescrewfixa6on.
![Page 18: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/18.jpg)
Advanced imaging • MostMRIandCTscannershaveweightlimitsthatconven6onallydonotexceed450lbs(202.5kg)• Zoo.
![Page 19: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/19.jpg)
Conclusion:
• Obesityisnotachoice,butratheracomplex,mul8factorialprocessthataffectsalargenumberofpa8entsandinmostcasescontributesnega8velytotheirmusculoskeletalproblems.• Itisequallyimportanttoassurethesafetyofhealthcarefacili8esaddressingthosesitua8onsspecifictotheobesepa8ent.
![Page 20: Obesity and musculoskeletal care general concepts](https://reader034.fdocuments.net/reader034/viewer/2022042906/5899ebb61a28ab96418b65dd/html5/thumbnails/20.jpg)
Thankyou