Total Diz Artroplastisi Sonrası Erken Dönemde Plantar Basınç Dağılımı Nasıl Değişir? Pilot Çalışma

Yıl 2019, Cilt: 41 Sayı: 4, 388 - 398, 01.10.2019

Meltem Isıntaş Arık , Özgen Aras , Hakan Akkan , Nilay Yürekdeler Şahin Vedat Kurt Cihan Caner Aksoy Alaaddin Oktar Üzümcügil

https://doi.org/10.20515/otd.441904

Öz

Total diz artroplasti (TDA) cerrahisi sonrasında ayak tabanındaki statik ve dinamik yüklenme paternlerinin nasıl
değiştiğini basınç platformu ile değerlendirmektir. Çalışmaya dahil olma
kriterlerini karşılayan 10 hasta (yaş ortalaması 68.5±7.9) alındı. Değerlendirmeler cerrahi öncesinde ve cerrahi
sonrası 15. günde yapıldı. Statik denge parametreleri (ayak ön-arka ve total
yük dağılımları, sağ-sol ayaklardaki ağrılık taşıma oranı, basınç merkezi elips
alanı ve salınım hızı) Zebris™ FDM-2
(zebris® Medical
GmbH, Germany)  cihazı ile
ölçülerek kaydedildi. Olguların
yürüme sırasında hasta tarafta arka ayakta oluşan maksimum kuvveti, bu kuvvetin
oluştuğu yürüme siklusundaki zaman yüzdesi ile orta ayak maksimum basınç
değerleri anlamlı olarak azaldığı bulundu (p<0,05). Olguların ayak rotasyon
dereceleri cerrahi sonrası azaldığı fakat bu azalmanın istatistiksel olarak
anlamlı olmadığı görüldü. Olguların, ayakta statik duruşta, ayağa binen toplam
yük, elips alanı, basınç merkezi (center of pressure (COP)) çizgi uzunluğu ve
COP ortalama hızı cerrahi öncesi ve sonrası ölçüm değerleri arasında anlamlı
bir fark bulunmadı (p>0,05). Hasta tarafta ayakta duruşta ön ayağa binen yük
ölçüm değerleri cerrahi sonrası anlamlı olarak artarken, arka ayağa binen yük
ölçüm değerleri anlamlı derecede azaldığı görüldü (p<0,05). TDA cerrahisi geçiren diz
osteoartritli hastalarda cerrahi sonrası 15. günde statik duruş sırasında arka
ayağa binen yük azalmış, ön ayağa binen yük artmıştır. Cerrahi öncesi ve sonrası kuvvet platformu
kullanılarak yapılan değerlendirmeler, ortopedik cerrahlar için yararlı
olabilir çünkü diz uyumunu düzeltmek için kullanılan TDA cerrahisi, erken
dönemde yükleme parametrelerini de etkilemektedir.

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Anahtar Kelimeler

ayak; diz osteoartriti; pedobarografi; total diz artroplastisi; yürüme analizi.

How does Plantar Pressure Distribution Change Early after Total Knee Arthroplasty? A Pilot Study

Öz

To evaluate how the static and dynamic plantar
overload distribution patterns change following total knee arthroplasty (TKA)
surgery using a pressure platform. Ten patients who met the inclusion criteria
were included (mean age 68.5±7.9 years). Evaluations were performed prior to
the surgery and on the 15th day after the surgery. Static balance parameters
(anterior-posterior and total load distribution of the foot, ratio of weight
bearing of the right and left foot, elliptic area of the pressure center and
oscillation speed) were measured and recorded by  Zebris™ FDM-2 (Zebris® Medical GmbH, Germany)
device. Maximum strength produced in the posterior foot during walking, time
percent of the walking cycle produced by this strength and middle foot maximum
pressure values were found to be significantly decreased (p<0,05). Rotation
degrees of the foot were found to be decreased in the patients, though not
statistically significant. No significant differences were found in the total
weight load on the foot, elliptic area, center of pressure (COP), line length
and mean COP rate during static standing between the pre-surgical and
post-surgical measurement results (p>0,05). Weight load measurement values
on the forefoot of the opere side during standing were found to be
significantly increased following surgery, while the weight load on the rear
foot was found to be significantly decreased (p<0,05).  The
weight load on the rear foot and forefoot upon static stance was decreased and
increased, respectively 15 days after the surgery in patients who underwent TKA
surgery. The
evaluations using force platform before and after surgery may be useful for
orthopedic surgeons because TKA surgery used to correct knee alignment also
affect loading parameters in early period.

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