FREQUENCY OF DELAYED COGNITIVE IMPAIRMENT AND OTHER CLINICAL TYPES OF POSTOPERATIVE BRAIN DYSFUNCTION IN HIP REPLACEMENT SURGERY

Much attention is paid to the study of postoperative complications in traumatology, since they affect the outcome of surgical treatment, the duration of hospitalization, and also reduce the quality of life of patients. Among the postoperative complications in patients with a traumatological profile, special attention is paid to changes in the functions of the central nervous system in the postoperative period, which constitute postoperative cerebral dysfunction - a change in the structural and functional state of the brain of predominantly vascular origin, which occurs in surgical practice in the intraoperative or early postoperative periods, manifested in the form of transient or persistent dysfunctions of the nervous system. Postoperative cerebral dysfunction is pathogenetically heterogeneous, clinically polymorphic, and includes three clinical types: perioperative cerebral stroke, symptomatic delirium of the early postoperative period, and delayed cognitive impairment. A feature of the development of postoperative cerebral dysfunction in orthopedics may be fat and bone marrow cerebral embolism, which most often occurs when cement fixation is used. Cerebral embolism contributes to damage to the blood-brain barrier, swelling of the brain substance. It can potentiate and participate in the mechanisms of neuroinflammation, leading to the development of the above clinical types of postoperative brain dysfunction. But despite the detection of fat emboli in the middle cerebral artery by transcranial dopplerography in many patients with endoprosthetics of large joints of the lower extremities, the connection of this fact with the development of postoperative cerebral dysfunction has not yet been studied.

postoperative cerebral dysfunction, perioperative stroke, symptomatic delirium of the early postoperative period, delayed cognitive impairment, traumatology, hip arthroplasty