**8. Neurological assessment**

• 7 MET heavy housework

56 Total Hip Replacement - An Overview

*patients*

• 0 0.4% • 1 0.9% • 2 7%

• >3 11%

period.

weight heparin (LMWH).

**7. Airway assessment**

• ≥10 MET heavy sports ability

*6.4.3. Cardiovascular drug management*

stent and intervention time:

II b/III a inhibitors) can be applied.

justed so that the heart rate is below 65/min.

• Dual treatment is continued without interruption.

neck, dental deterioration and cervical joint degeneration.

*6.4.2. Cardiovascular risk assessment: the Lee risk index is the most appropriate for orthopedic* 

• Antihypertensive agents should not be discontinued until morning of the operation.

• Beta blockers should not be discontinued until an operation; the drug dose should be ad-

• Aspirin reduces the risk of deep vein thrombosis and pulmonary embolism. The use of aspirin alone provides suboptimal protection for thromboembolic events associated with hip fractures. It is imperative that aspirin should be continued for stapled, drug-free stents.

• Thienopyridine (clopidogrel and ticlopidine) combined with dual use of aspirin is associated with the use of coronary stent. Dual use increases the possibility of bleeding by 0.4–1.0% compared with aspirin treatment alone. Three ways may be followed based on the type of

• Bridging therapy with antithrombotic agents (low molecular weight heparin, glycoprotein

• Thienopyridine treatment is discontinued 10 days before surgery and resumed in a safe

Antithrombotic agents; fondaparinux, unfractionated heparin (UFH) and low molecular

There is a risk of difficult mask ventilation and difficult intubation due to hardness in the

Number of current risks and incidence of cardiac complications

In the group of patients planned for arthroplasty, weakening of the memory, decrease in cognitive and intellectual functions, diminished movements, deterioration of sleep order, decrease in visual, acoustical, taste and smell sensation, autonomic nervous system imbalances, Parkinson, depression and dementia are common. If there is a suspicion of a mental condition of the patient, the mental status test (Mini Mental Status Test) can be planned.

## **9. Renal assessment**

There is a risk of renal insufficiency and preoperative azotaemia related to age. Prerenal azotaemia should be corrected by hydration, by taking patients into dialysis program if necessary and by optimizing biochemical values.
