Ünikondiler diz artroplastisinde posteromedial kompartmanda kalan fazla sement

Öz

Ünikondiler diz protezi (UDP) sonrası arka kompartmanda fazla sement kalmasına bağlı akut mekanik semptomlar nadirdir. Enfeksiyon, aseptik gevşeme, polietilen aşınması ve ilerleyici artrit bu prosedürün iyi bilinen komplikasyonları arasında yer almaktadır. Bu çalışmada, UDP sonrası posteromedial kompartmanda sement taşmasına bağlı akut ağrı ve dizde ‘tıklama’ hissi olan, sement parçasının artroskopik olarak çıkarılmasını takiben tam fonksiyonel kazanım elde edilen hastayı sunmaktayız. Retrospektif olarak değerlendirilen 43 UDP olgusundan sekizinde direkt grafilerde asemptomatik sement dışa çıkması gözlendi. Sementin posterior kompartmana taşma riskini en aza indirgemek için komponentlerin dikkatli gözlemi çok önemli olup ameliyat sırasında alınacak floroskopik görüntüler bu konuda yardımcı olabilir.

Anahtar Kelimeler

• Ağrı; artroplasti; artroskopi; kemik sementi; yabancı cisim

Excess retained cement in the posteromedial compartment after unicondylar knee arthroplasty

Abstract

Acute mechanical symptoms due to excess retained cement in the posterior compartment of the knee joint following unicondylar knee arthroplasty (UKA) are uncommon. Infection, aseptic loosening, polyethylene wear and progressive arthritis are well-documented complications of UKA procedure. We present a patient with acute pain and ‘clicking’ sensation in the knee joint due to cement extrusion in the posteromedial compartment after UKA. Full functional recovery was achieved after arthroscopic removal of the cement debris. Of retrospectively screened 43 UKA cases, asymptomatic cement extrusion was detected in 8 patients in the posteromedial compartment on direct X-rays. Careful inspection of components is essential to minimize the risk of cement extrusion into the posterior compartment and perioperative fluoroscopy may be helpful during UKA procedure.

Keywords

• Arthroplasty
• arthroscopy
• bone cement
• foreign body
• pain

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