Primer Diz Osteoartritinde Total Diz Artroplastisi ve Konservatif Tedavi Sonrası Ağrı, Fiziksel Aktivite Düzeyi ve Fonksiyonellik

Abstract

Amaç: Diz eklemi osteoartritin en sık tuttuğu eklemdir ve diz osteoartriti ile ilişkili ağrı, günlük yaşam aktivitelerini kısıtlayarak fonksiyonel yetersizliğe yol açar. Bu araştırmanın amacı, primer diz osteoartriti nedeniyle total diz artroplastisi ve konservatif tedavi uygulanan hastaların tedavi sonrası ağrı, fiziksel aktivite ve fonksiyonellik düzeylerinin karşılaştırılmasıdır. Gereç ve Yöntemler: Çalışmaya diz osteoartriti tanısı ile total diz artroplastisi uygulanan 30, konservatif tedavi olarak fizyoterapi uygulanan 30 ve 36 sağlıklı kontrol olmak üzere toplam 96 olgu dahil edildi. Ağrı düzeyi Vizuel Analog Skala ile, fiziksel aktivite Uluslararası Fiziksel Aktivite Anketi kısa form ile, semptom ve fonksiyonel durum Western Ontario ve McMaster Üniversiteleri Osteoartrit İndeksi ve Oxford Diz Skoru ile değerlendirildi. Değerlendirmeler cerrahi ve konservatif tedavi sonrası 3 – 6 ay arasında olmak üzere bir kez gerçekleştirildi. Bulgular: Sonuçlar konservatif ve cerrahi tedavi uygulanan hastaların sağlıklı kontrollere göre vücut kitle indekslerinin daha yüksek olduğunu (p=0,001), fiziksel aktivite düzeylerinin daha düşük olduğunu (p<0,001) göstermiştir. Konservatif tedavi uygulanan hastaların ağrı düzeylerinin daha düşük olduğu ancak total diz artroplastisi uygulanan hastaların fonksiyonel seviyelerinin daha iyi olduğu belirlenmiştir. Sonuç: Tedavi sonrasında cerrahi tedavi uygulanan hastaların ağrı düzeylerinin daha düşük olduğu ve fonksiyonel seviyelerinin daha iyi olduğu belirlenmiştir. Kilo kontrolünün sağlanması ile diz osteoartritine bağlı semptomlar azaltılabilir ve cerrahi tedavi geciktirilebilir. Cerrahi sonrası dönemde hastaların ağrı düzeylerinin azaltılması ve fiziksel aktivite düzeylerinin geliştirilmesi için hastalar ortopedik rehabilitasyon programlarına yönlendirilmelidir.

Keywords

• diz
• osteoartrit
• total diz artroplastisi
• rehabilitasyon

Pain, Physical Activity Level and Functionality in Primary Knee Osteoarthritis after Total Knee Arthroplasty and Conservative Treatment

Abstract

Aim: The knee joint is the most commonly involved joint in osteoarthritis, and pain associated with knee osteoarthritis leads to functional impairment by limiting daily living activities. The aim of this study was to compare pain, physical activity and functionality levels of patients applied with surgical or conservative treatment for primary knee osteoarthritis. Material and Methods: Total knee arthroplasty was applied to 30 patients, conservative physiotherapy treatment to 30 patients and a control group was formed of 36 age-matched healthy individuals. Pain was assessed with a Visual Analogue Scale, physical activity with the International Physical Activity Questionnaire short form, symptoms and functional status with the Western Ontario and McMaster University Osteoarthritis Index and the Oxford Knee Score. Assessments were made once at 3-6 months after surgical and conservative treatment. Results: The results showed that body mass index was higher (p=0.001) and physical activity levels were lower (p<0.001) in patients who underwent conservative and surgical treatment compared to the healthy control group. Pain levels were lower and functional levels were better in patients who had undergone total knee arthroplasty. Conclusion: Pain levels were lower and functional levels were better in patients who received surgical treatment. Weight control can relieve symptoms related to knee osteoarthritis and help to avoid surgical treatment. Patients should be referred to orthopedic rehabilitation programs to reduce pain and improve physical activity levels in the postoperative period.

Keywords

• Knee
• osteoarthritis
• total knee replacement
• rehabilitation

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