Hyalonect'in psödoartroz tedavisinde kullanımı

Öz

Amaç: Bu çalışmamızda, ekstrasellüler matrisin doğal bir bileşeni olan, hyaluronik asidin benzil esteri HYAFF’tan oluşan ve örgülü yapıda bir malzeme olan Hyalonect’in psödoartroz tedavisinde kullanımına dair kaynama oranları ve komplikasyonları değerlendirildi. Çalışma planı: Çalışmaya, psödoartrozun tedavisi için Hyalonect ile cerrahi girişimde bulunulan ve yaş ortalaması 44.6 (dağılım: 23-57) olan 11 hasta (8 erkek, 3 kadın) dahil edildi. İlk tedavi ile cerrahi girişim arasında geçen süre ortalama 12.9 (dağılım: 8-48) ay idi. Dört hastada tibiada, 2 hastada femurda ve 5 hastada humerusta psödoartroz mevcuttu. Hastalara daha evvel 1 ila 6 kez cerrahi girişim uygulanmıştı. Tüm hastalara açık redüksiyon ve internal tespit yapıldı. Kırık bölgesine allogreft uygulandı ve etrafı Hyalonect ile sarıldı. Ortalama takip süresi 31 (dağılım: 12-48) ay olarak kaydedildi. Bulgular: Tüm olgularda ortalama 6 (dağılım: 4-8) ayda kaynama elde edildi. Hastaların birinde yaklaşık 2 hafta kadar süren bir akıntı saptandı. Enfeksiyon gelişen diğer bir hasta uygun antibiyotik tedavisine cevap verdi. Kötü kaynama veya implant yetersizliği gözlenmedi. Bir hastada daha önceden var olan radyal sinir felcinin devam ettiği görüldü. Çıkarımlar: Özellikle enfekte olmayan psödoartrozların cerrahi tedavisinde Hyalonect kullanımının güvenilir olduğu ve kaynama üzerine pozitif etkisi olduğu düşünülmektedir.

Anahtar Kelimeler

• Cerrahi örtüm aparatı; Hyalonect; hyaluronik asit; kaynamama; psödoartroz

Hyalonect in the treatment of pseudarthrosis

Abstract

Objective: The aim of this study was to evaluate union rates and complications of Hyalonect, a knitted mesh composed of HYAFF, a benzyl ester of hyaluronic acid, and a naturally occurring constituent of the extracellular matrix, for the treatment of pseudarthrosis.
Methods: The study included 11 patients (8 male, 3 female; mean age: 44.6 years; range: 23 to 57 years) operated for pseudarthrosis using Hyalonect. Average time between initial treatment and surgical procedure was 12.9 (range: 8 to 48) months. Pseudarthrosis of the tibia, femur and humerus was present in 4, 2 and 5 patients, respectively. All patients had undergone prior surgery (1 to 6 times). Each patient underwent open reduction and internal fixation. Allograft was applied to the pseudarthrosis area and covered with Hyalonect. Mean follow up period was 31 (range: 12 to 48) months.
Results: Union was achieved in all patients after an average of 6 (range: 4 to 8) months. One patient had a discharge for two weeks. Another developed an infection which responded well to appropriate antibiotic treatment. No malunion or implant failure was observed. One patient with pre-existing radial nerve palsy maintained the condition.
Conclusion: Use of Hyalonect appears to be a safe method with a positive impact on union in the surgical treatment of pseudarthrosis, particularly in the absence of any infection.

Keywords

• Hyalonect
• hyaluronic acid
• nonunion
• pseudarthrosis
• surgical mesh

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