Total diz protezinde eklem hareket açıklığı ile femoral rollback arasındaki ilişki

Öz

Amaç: Bu çalışmanın amacı bağ koruyan (BK) ve posterior stabilize (PS) total diz protezli (TDP) hastalarda femoral rollback ile eklem hareket açıklığı (EHA) arasındaki ilişkiyi karşılaştırmaktı. Çalışma planı: Primer diz artrozu bulunan ve TDP ameliyatı geçirmiş 31 hastanın (26 kadın ve 5 erkek) 38 dizi çalışmaya alındı. PS grubundaki 24 dizde arka çapraz bağ (AÇB) feda edilirken, BK grubundaki 14 AÇB korundu. Hastaların ortalama takip süresi 30.6 ay idi. Hastaların EHA ile femoral rollback değerlendirmesi için lateral skopiden yararlanıldı. Bulgular: Ortalama EHA’nın BK grubunda 106.43±9º, PS grubunda 105.43±11.7º olduğu saptandı (p=0.78). Ortalama femoral rollback 10.5±9.7 mm iken, BK grubundaki ölçümün (5.8±6.5 mm) PS grubuna (13.2±10.5 mm) göre anlamlı derecede düşük olduğu belirlendi (p=0.026615). BK protezlerin değerlendirilmesinde femoral rollback ile EHA arasında korelasyon bulunamazken (p=0.78 and r=0.8), PS protezlerde anlamlı korelasyon saptandı (p=0.01 and r=0.49). Regresyon analizinde her femoral rollback birimi için EHA’nın 0.545 derece arttığı belirlendi. Çıkarımlar: Posterior stabilize TDP’de femoral rollback artmış ve EHA ile ilişkili olduğu halde, BK TDP ve PS TDP arasında EHA açısından bir fark bulunamamıştır.

Anahtar Kelimeler

• Eklem hareket açıklığı; femoral rollback; total diz protezi.

Relationship between range of motion and femoral rollback in total knee arthroplasty

Abstract

Objective: The aim of this study was to evaluate the relation between femoral rollback and range of motion (ROM) in patients with cruciate retaining (CR) and posterior stabilized (PS) total knee arthroplasty (TKA).
Methods: The study included 38 knees of 31 patients (26 female and 5 male) with primary knee arthrosis who underwent TKA. The posterior cruciate ligament (PCL) was sacrificed in 24 knees in the PS group and preserved in 14 in the CR group. Mean follow-up was 30.6 months. Patients were submitted to fluoroscopic lateral evaluation for ROM and femoral rollback assessment.
Results: Average ROM of the CR group was 106.43±9º and 105.43±11.7º for the PS group (p=0.78). Average femoral rollback was 10.5±9.7 mm and was significantly lower in the CR group (5.8±6.5 mm) than the PS group (13.2±10.5 mm) (p=0.026615). While there was no correlation between the femoral rollback and ROM for CR prostheses (p=0.78 and r=0.8), there was a significant correlation for PR prostheses (p=0.01 and r=0.49) with regression pointing to an increase of 0.545 degrees ROM for each unit of femoral rollback.
Conclusion: Despite increase in femoral rollback and its relation with ROM in PS TKA, there were no differences in ROM between CR and PS TKA.

Keywords

• Femoral rollback
• range of motion
• total knee arthroplasty

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