Öz
Amaç: Bu çalışmada; kliniğimizde yapılan total
diz artroplastisi (TDP) olguları geriye dönük olarak incelendi ve klinik
sonuçlarımız güncel literatür eşliğinde tartışıldı.
Hastalar ve yöntem: Bu çalışmaya Kliniğimizde TDP
yapılan 51 hastadan yeterli takipleri bulunan 40 hastanın 65 dizi dâhil
edilmiştir. Hastalara preoperatif ve postoperatif dönemde, Amerikan Diz
Cemiyetinin (Knee Society) revize etmiş olduğu skorlama sistemleri yüz yüze
görüşülerek doldurtularak değerlendirildi.
Bulgular: Hastaların yaş dağılımı 54–75 (ortalama
61.15) idi. Takip süresi ise 11–74 ay (ort.29.3 ay) arasında
değişiyordu. Ameliyat öncesinde hastaların diz hareket açıklığı 60°-95°
(ort.77.3°) arasında değişmekte iken ameliyat sonrası dönemde 100°–120°
(ort.114.4°) arasında idi (p=0.03). Olguların radyolojik değerlendirmelerin de;
ameliyat öncesi dönemde 60 dizde (%92.3) varus dizilimi, 5 dizde (%7.7) ise
valgus dizilimi mevcuttu. Ameliyat sonrası dönemde ise 14 dizde (%21.5) varus
dizilimi, 19 dizde (%29.2) nötral dizilim, 32 dizde (%49.3) ise valgus dizilimi
mevcuttu. Skoru ise; ameliyat öncesi dönemde 35– 68 (ort.44.8) arasında; kötü̈
olarak değerlendirildi, Ameliyat sonrası dönemde ise diz skoru 72–96
(ort.86.3) arasında iyi olarak bulunmuştur.
Sonuç: Total diz protezi cerrahisi özellikle
konservatif tedavilere yanıt vermeyen ileri eklem dejenerasyonu ve
destrüksiyonu olan ve şiddetli diz ağrısı çeken hastalar için ağrının
giderilmesinde başarılı bir tedavi yöntemidir.
Anahtar Kelimeler
Kaynakça
- 1. Guyton JL. Arthroplasty of ankle and knee. Canale T (Editör). Campbell’s Operative Orthopaedics. 10. edition. St. Louis: Mosby-Year Book, Inc. 2003: 243–298.
- 2. Burke DW, O’Flynn H. Primary total knee arthroplasty. Chapman MW (Editör).Chapman’s Orthopaedic Surgery. 3rd edition, Lippincott Williams&Wilkins, 2001:2869–2895.
- 3. Ege R: Diz Anatomisi. Ege R. (Editör). Diz sorunları. 1. baskı. Ankara: BizimBüro Basımevi, 1998: 27–54.
- 4. Gill GS, Joshi AB, Mills DM. Total condylar knee arthroplasty. 16- to 21-year results. Clin Orthop Relat Res 1999; 367: 210–215.
- 5. Mancuso CA, Ranawat CS, Esdaile JM, Johanson NA, Charlson ME. Indications for total hip and total knee arthroplasties. J Arthroplasty 1996; 1: 34–46.
- 6. Harris WH, Sledge CB. Total hip and total knee replacement (Second of two parts). The New England Journal of Medicine 1990; l2: 801–807.
- 7. Noble J, Hilton RC. Total knee replacement. Getting better all the time. BMJ 1991; 303: 262.
- 8. Bourne RB, McCalden RW, MacDonald SJ, Mokete L, Guerin J. Influence of patient factors on TKA outcomes at 5 to 11 years followup. Clin Orthop Relat Res 2007; 464: 27–31.
- 9. Malkani AL, Rand JA, Bryan RS. Total knee arthroplasty with KinematicCondylar Prosthesis. A ten-year follow-up study. J Bone Joint Surg 1995; 77 (3): 423–431.
- 10. Nozaki H, Banks SA, Suguro T. Observations of femoral rollback in cruciate retaining knee arthroplasty. Clin Orthop Relat Res 2002; 404: 308–314.
- 11. Colizza W, Insall JN, Scuderi GR. The posterior stabilized total knee prosthesis. Assessment of polyethylene damage and osteolysis after a ten-year-minimum followup. J Bone Joint Surg 1995; 77A: 1713 – 1720.
- 12. Clarck CR, Rorabeck CH, Swafford J, Cleland D. Posterior stabilized and cruciate retaining total knee arthrolasty. Clin Orthop 2001; 392: 208–212.
- 13. Lombardi AV Jr, Mallory TH, Fada RA, Hartman JF, Capps SG, Kefauver CA, Adams JB. An algorithm for the posterior cruciate ligament in total knee arthroplasty. Clin Orthop 2001; 392: 75–78.
- 14. Scott RD, Reilly DT. Pros and cons of patella resurfacing in total knee replacement. Orthop Trans 1980; 4: 328–331.
- 15. Üstüner Y.Total Diz Artroplastisi Orta Dönem Sonuçları. Uzmanlık Tezi, İstanbul: Haseki Egitim ve Arastırma Hastanesi, Ortopedi ve Travmatoloji Klinigi, 2006.
- 16. Mcpherson EJ. Adult Reconstruction. Miller MD (editör). Review of orthopaedics. 4th Edition. Philadelphia: Saunders, 2004: 284–298
- 17. Wasielewski RC, Parks N, Collier JP. Tibial insert undersurface as a contributing source of polyethylene wear debris. Clin Orthop Relat Res 1997; 345: 53–59.
- 18. Noble PC, Conditt MA, Thompson PE. Extrarticular abrasive wear in cemented and cementless total knee arthroplasty. Clin Orthop Relat Res 2003; 416: 120–128.
Öz
Aim: In this study, we retrospectively evaluated our total
knee arthroplasty outcomes and discussed our results with the current
literature.
Patient and
Methods: From 51 patients, 40 patients 65
knees were included to the study after excluding patients with enough
follow-up. Revised by American Knee Society, scoring systems filled by patients
with face to face encounter before and after surgery were collected.
Results: Age range of the patients were 54 to 75 (mean 61.15)
years. Range of the follow-up was 11 to 74 (mean 29.3) months. Range of the
preoperative knee range of motion was 60° to 95° (77.3°) and postoperative
range of motion was 100° to 120° (mean114.4°) (p:0.03). Radiological
preoperative evaluation of the patients revealed that 60 (92.3%) knees had
varus alignment and 5(7.7%) knees had valgus alignment. Postoperatively, 14
knees (21.5%) had varus, 19(29.2%) knees had neutral and 32(49.3%) knees had valgus
alignment. Preoperative Scores were low with a range of 35 to 68 (mean 44.8).
Postoperative knee scores were good with a range of 72 to 96 (mean 86.3).
Conclusion: Total knee arthroplasty surgery is a good treatment
option especially for the patients with severe joint degeneration and
destruction, which are not be able to be treated with conservative treatments,
and also in pain relief in patients with severe knee pain.
Anahtar Kelimeler
Kaynakça
- 1. Guyton JL. Arthroplasty of ankle and knee. Canale T (Editör). Campbell’s Operative Orthopaedics. 10. edition. St. Louis: Mosby-Year Book, Inc. 2003: 243–298.
- 2. Burke DW, O’Flynn H. Primary total knee arthroplasty. Chapman MW (Editör).Chapman’s Orthopaedic Surgery. 3rd edition, Lippincott Williams&Wilkins, 2001:2869–2895.
- 3. Ege R: Diz Anatomisi. Ege R. (Editör). Diz sorunları. 1. baskı. Ankara: BizimBüro Basımevi, 1998: 27–54.
- 4. Gill GS, Joshi AB, Mills DM. Total condylar knee arthroplasty. 16- to 21-year results. Clin Orthop Relat Res 1999; 367: 210–215.
- 5. Mancuso CA, Ranawat CS, Esdaile JM, Johanson NA, Charlson ME. Indications for total hip and total knee arthroplasties. J Arthroplasty 1996; 1: 34–46.
- 6. Harris WH, Sledge CB. Total hip and total knee replacement (Second of two parts). The New England Journal of Medicine 1990; l2: 801–807.
- 7. Noble J, Hilton RC. Total knee replacement. Getting better all the time. BMJ 1991; 303: 262.
- 8. Bourne RB, McCalden RW, MacDonald SJ, Mokete L, Guerin J. Influence of patient factors on TKA outcomes at 5 to 11 years followup. Clin Orthop Relat Res 2007; 464: 27–31.
- 9. Malkani AL, Rand JA, Bryan RS. Total knee arthroplasty with KinematicCondylar Prosthesis. A ten-year follow-up study. J Bone Joint Surg 1995; 77 (3): 423–431.
- 10. Nozaki H, Banks SA, Suguro T. Observations of femoral rollback in cruciate retaining knee arthroplasty. Clin Orthop Relat Res 2002; 404: 308–314.
- 11. Colizza W, Insall JN, Scuderi GR. The posterior stabilized total knee prosthesis. Assessment of polyethylene damage and osteolysis after a ten-year-minimum followup. J Bone Joint Surg 1995; 77A: 1713 – 1720.
- 12. Clarck CR, Rorabeck CH, Swafford J, Cleland D. Posterior stabilized and cruciate retaining total knee arthrolasty. Clin Orthop 2001; 392: 208–212.
- 13. Lombardi AV Jr, Mallory TH, Fada RA, Hartman JF, Capps SG, Kefauver CA, Adams JB. An algorithm for the posterior cruciate ligament in total knee arthroplasty. Clin Orthop 2001; 392: 75–78.
- 14. Scott RD, Reilly DT. Pros and cons of patella resurfacing in total knee replacement. Orthop Trans 1980; 4: 328–331.
- 15. Üstüner Y.Total Diz Artroplastisi Orta Dönem Sonuçları. Uzmanlık Tezi, İstanbul: Haseki Egitim ve Arastırma Hastanesi, Ortopedi ve Travmatoloji Klinigi, 2006.
- 16. Mcpherson EJ. Adult Reconstruction. Miller MD (editör). Review of orthopaedics. 4th Edition. Philadelphia: Saunders, 2004: 284–298
- 17. Wasielewski RC, Parks N, Collier JP. Tibial insert undersurface as a contributing source of polyethylene wear debris. Clin Orthop Relat Res 1997; 345: 53–59.
- 18. Noble PC, Conditt MA, Thompson PE. Extrarticular abrasive wear in cemented and cementless total knee arthroplasty. Clin Orthop Relat Res 2003; 416: 120–128.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Cerrahi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Mart 2018 |
| Gönderilme Tarihi | 28 Aralık 2017 |
| Kabul Tarihi | 22 Ocak 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 2 Sayı: 1 |
Cited By
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