{"id":928,"date":"2019-09-02T07:41:07","date_gmt":"2019-09-02T07:41:07","guid":{"rendered":"https:\/\/ingenieriadebarcelona.es\/?p=928"},"modified":"2019-09-02T07:42:43","modified_gmt":"2019-09-02T07:42:43","slug":"quien-no-es-candidato-a-una-protesis-de-rodilla-o-cadera","status":"publish","type":"post","link":"https:\/\/ingenieriadebarcelona.es\/?p=928","title":{"rendered":"\u00bfQUI\u00c9N NO ES CANDIDATO A UNA PROTESIS DE RODILLA O CADERA?"},"content":{"rendered":"<p>En anteriores ocasiones, hemos hablado de qui\u00e9nes deben ser los candidatos s recibir una operaci\u00f3n de pr\u00f3tesis de cadera, rodilla u hombro pero hoy, hablaremos de aquellos pacientes que <strong>no deben recibir una pr\u00f3tesis<\/strong> y el porqu\u00e9 de ser excluidos. Cabe destacar, que la elecci\u00f3n de los candidatos es fundamental ya que, una buena elecci\u00f3n marcar\u00e1 el \u00e9xito a largo plazo del implante prot\u00e9sico.<\/p>\n<p>&nbsp;<\/p>\n<p>\u00bfCU\u00c1NDO NO DEBEMOS IMPLANTAR UNA PR\u00d3TESIS DE CADERA Y DE RODILLA?<\/p>\n<p>S\u00ed bien es cierto, existen algunas contradicciones a la hora de implantar las pr\u00f3tesis de cadera y de rodilla, de forma muy breve te exponemos cu\u00e1les son las principales dicotom\u00edas:<\/p>\n<ol>\n<li>Si el paciente presenta una <strong>infecci\u00f3n activa de rodilla o cadera<\/strong>, la implementaci\u00f3n de una pr\u00f3tesis empeorar\u00eda la infecci\u00f3n y podr\u00eda darse un caso de riesgo de muerte del paciente.<\/li>\n<li>En caso que el <strong>paciente presente una infecci\u00f3n remota en estado activo <\/strong>y fuera de control, ya sea en <strong>la boca, orina, genital, pulm\u00f3n o lesiones cut\u00e1neas <\/strong>la intervenci\u00f3n, de nuevo, pondr\u00eda en riesgo al paciente.<\/li>\n<li>Si el paciente presenta <strong>un cuadro de s\u00edndrome de inmunodeficiencia adquirida<\/strong> (SIDA) incontrolado y no tratado no se podr\u00e1 ejecutar la intervenci\u00f3n. Al mismo tiempo, tampoco se podr\u00e1 realizar la operaci\u00f3n aunque el paciente <strong>est\u00e9 siendo tratado con cargas virales indetectables y recuentos de CD4&gt; 350.<\/strong><\/li>\n<\/ol>\n<ol start=\"4\">\n<li>En caso que el doliente presente una <strong>enfermedad neurol\u00f3gica r\u00e1pidamente progresiva el implante prot\u00e9sico no ser\u00eda lo m\u00e1s adecuado. <\/strong>Cabe destacar que el <em>genu recurvatum <\/em>secundario a enfermedad neuromuscular esta considerado contraindicaci\u00f3n relativa para la pr\u00f3tesis de rodilla. No obstante, la enfermedad neurol\u00f3gica de <em>Mildner<\/em> no es una contraindicaci\u00f3n para pr\u00f3tesis de cadera o rodilla pero debe tratarse con sumo cuidado quir\u00fargico.<\/li>\n<\/ol>\n<ol start=\"5\">\n<li>Las patolog\u00edas medicas concurrentes que puedan comprometer la vida del paciente a causa de la cirug\u00eda o de la anestesia (por ejemplo: insuficiencia cardiaca, pulmonar, renal, hep\u00e1tica, etc)<\/li>\n<\/ol>\n<ol start=\"6\">\n<li>Aquellos pacientes no colaboradores a causa de una patolog\u00eda neurol\u00f3gica (demencia) o psiqui\u00e1trica que les impida colaborar y seguir las instrucciones y rehabilitaci\u00f3n pertinentes, no se recomendar\u00e1 realizar la intervenci\u00f3n quir\u00fargica.<\/li>\n<\/ol>\n<ul>\n<li>Si el doliente presenta una<strong> diabetes descontrolada<\/strong> <strong>(glucosa &gt;200 mg\/L o HbA1C&gt;7%) <\/strong>no se recomendar\u00e1 hacer una implantaci\u00f3n de pr\u00f3tesis ya que ello incrementa de forma notabil\u00edsima el riesgo de infecci\u00f3n.<\/li>\n<li>Si existe una artrodesis de rodilla o cadera indoloras y en buen funcionamiento pasar por quir\u00f3fano no ser\u00e1 la mejor opci\u00f3n.<\/li>\n<\/ul>\n<p>En el pr\u00f3ximo cap\u00edtulo comentaremos las contraindicaciones relativas y los casos complejos que hay que tratar con especial cuidado para que el resultado sea \u00f3ptimo.<\/p>\n<p>&nbsp;<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"size-full wp-image-925 aligncenter\" src=\"https:\/\/ingenieriadebarcelona.es\/wp-content\/uploads\/2019\/09\/Imagen-2.jpg\" alt=\"\" width=\"500\" height=\"218\" srcset=\"https:\/\/ingenieriadebarcelona.es\/wp-content\/uploads\/2019\/09\/Imagen-2.jpg 500w, https:\/\/ingenieriadebarcelona.es\/wp-content\/uploads\/2019\/09\/Imagen-2-300x131.jpg 300w\" sizes=\"(max-width: 500px) 100vw, 500px\" \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>En anteriores ocasiones, hemos hablado de qui\u00e9nes deben ser los candidatos s recibir una operaci\u00f3n de pr\u00f3tesis de cadera, rodilla u hombro pero hoy, hablaremos de aquellos pacientes que no deben recibir una pr\u00f3tesis y el porqu\u00e9 de ser excluidos. Cabe destacar, que la elecci\u00f3n de los candidatos es fundamental ya que, una buena elecci\u00f3n &#8230; <a title=\"\u00bfQUI\u00c9N NO ES CANDIDATO A UNA PROTESIS DE RODILLA O CADERA?\" class=\"read-more\" href=\"https:\/\/ingenieriadebarcelona.es\/?p=928\" aria-label=\"Leer m\u00e1s sobre \u00bfQUI\u00c9N NO ES CANDIDATO A UNA PROTESIS DE RODILLA O CADERA?\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":925,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15,16,10,11,9,22,6],"tags":[39],"class_list":["post-928","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articulos","category-cadera","category-doctores","category-dr-antoni-fraguas-castany","category-especialidad","category-rodilla","category-traumatologia","tag-dr-antoni-fraguas-castany"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u00bfCu\u00e1ndo no debemos implantar una pr\u00f3tesis de cadera y de rodilla? 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