Outpatient Surgery Magazine

The Power to Prevent SSIs - June 2017 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/836658

Contents of this Issue


Page 109 of 132

patient's anatomy; • surgeons better understand who is going to be a good candidate for the surgery; and • surgeons can better perform the surgery, thanks to shifts in technolo- gy and technique. Let's examine 4 factors that have helped to fuel the demand for unis. 1 Patient selection In 1989, Brigham and Women's Hospital orthopods Stuart C. Kozinn, MD, and Richard Scott, MD, wrote a landmark paper about the indications used to determine who was a good candidate for this surgery (osmag.net/bKQ6vX). In it, the 2 surgeons offered a rather conservative definition of an ideal candidate: no one weighing more than 180 pounds; no one younger than 60; no one who had more than minimal erosive changes in patellofemoral articulation; and no one who was physically active or performing heavy labor. Based on those strict criteria, the field of acceptable candidates was limited to less than 15% of patients with osteoarthritic knees. Thankfully, our understanding has grown considerably in the years since. Take obesity as just one example. Obesity is now a relative con- traindication, as the patient's bone quality and weight distribution — not just BMI — must also be considered. In my practice, we encour- age patients to lose weight before surgery for 2 reasons: First, obese patients are more likely to experience perioperative complications, such as infection and blood clots; and second, having a patient trim down to a healthier weight is critical for not only the longevity of the knee but also for the overall well-being of the patient. And as for the age factor, both younger and older patients have shown excellent medium- and long-range results with unis. With a uni, there's less opportunity to change the anatomy. So if the 1 1 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 7

Articles in this issue

Links on this page

Archives of this issue

view archives of Outpatient Surgery Magazine - The Power to Prevent SSIs - June 2017 - Subscribe to Outpatient Surgery Magazine