Sabit-İnsörtlü ve Mobil-İnsörtlü Unikondiler Diz Artroplastisi: Benzer Komponent ve Mekanik Eksen Dizilimine Sahip Hastaların Karşılaştırması

Year 2022, Volume: 24 Issue: 3, 293 - 298, 30.12.2022

Murat Saylık Selim Ergün Taner Güneş

https://doi.org/10.18678/dtfd.1182098

Abstract

Amaç: Unikondiler diz artroplastisi (UDA), dizin bir kompartmanı ile sınırlı artritli hastalar için tedavi seçenekleri arasındadır. Sabit-insört (Sİ) ve mobil-insört (Mİ) eki mevcuttur. Bu çalışmada, Sİ-UDA ve Mİ-UDA ile ameliyat edilen hastaların fonksiyonel ve klinik sonuçlarının ve revizyon oranlarının karşılaştırılması amaçlandı.
Gereç ve Yöntemler: Toplam olarak, 118 hastanın 131 dizine çimentolu UDA uygulandı ve ortalama takip süresi Sİ-UDA için 80,58±31,31 ay ve Mİ-UDA için 97,66±29,24 ay oldu. Klinik ve fonksiyonel değerlendirme, Knee Society Skor (KSS) ve Western Ontario and McMaster Universitesi Artrit Indeks (WOMAC) skoru ile son takip ziyaretinde yapıldı. Radyolojik ve fonksiyonel sonuçlar, komplikasyon ve revizyon oranlarını etkileyen faktörler üç ana başlık altında incelendi; i) cerrahla ilgili, ii) hastayla ilgili ve iii) bileşen hizalamayla ilgili faktörler.
Bulgular: Gruplar arasında yaş, cinsiyet, vücut kitle endeksi ve yan açısından anlamlı bir fark yoktu. KSS skorlarına göre 9 (%6,87) diz kabul edilebilir sınırlar içinde, 62 (%47,32) diz iyi olarak ve 60 (%45,80) diz ise mükemmel olarak bulundu. Gruplar arasında istatistiksel olarak anlamlı bir fark bulunmadı (p=0,497). WOMAC skorları ile ilgili olarak, Mİ-UDA grubu anlamlı olarak daha düşük ağrı (p=0,049) ve sertlik (p=0,014), ancak benzer fonksiyonel skorlara (p=0,591) sahipti. Revizyon oranları açısından istatistiksel olarak anlamlı bir fark yoktu (p=0,931).
Sonuç: Benzer klinik, fonksiyonel ve radyolojik sonuçlar ve düşük revizyon oranları bulundu. Ağrı ve eklem sertliği açısından gruplar arasında Mİ-UDA lehine anlamlı bir fark bulundu.

Keywords

diz, sabit insörtlü, mobil insörtlü, unikondiler

Fixed-Bearing versus Mobile-Bearing Unicondylar Knee Arthroplasty: Comparison of Patients with Similar Component and Mechanical Axis Alignment

Abstract

Aim: Unicondylar knee arthroplasty (UKA) is among the treatment options for patients with arthritis limited to one compartment of the knee. Fixed-bearing (FB) and mobile-bearing (MB) inserts are present. This study aimed to compare functional and clinical outcomes and revision rates of patients operated with FB-UKA and MB-UKA.
Material and Methods: A total of 131 knees of 118 patients underwent cemented UKA, with a mean follow-up period of 80.58±31.31 months for FB-UKA and 97.66±29.24 months for MB-UKA. Clinical and functional evaluation was performed by the Knee Society Score (KSS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, at the last follow-up visit. The factors affecting the radiological and functional results, complication, and revision rates were examined under three main titles; i) surgeon-related, ii) patient-related, and iii) component alignment-related factors.
Results: There was no significant difference between the groups in terms of age, gender, body mass index, and side. Regarding the KSS scores, 9 (6.87%) knees were within acceptable limits, 62 (47.32%) knees were found to be good, and 60 (45.80%) knees were found to be excellent. No statistically significant difference was found between groups (p=0.497). Regarding the WOMAC scores, the MB-UKA group had significantly lower pain (p=0.049) and stiffness (p=0.014), but similar functional (p=0.591) scores. There was no statistically significant difference regarding revision rates (p=0.931).
Conclusion: Similar clinical, functional, and radiological results and low revision rates were found. In terms of pain and joint stiffness, a significant difference was found between groups, in favor of MB-UKA.

Keywords

knee, fixed-bearing, mobile-bearing, unicondylar

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