ÇİMENTOSUZ TOTAL KALÇA ARTROPLASTİSİ: KISA VE ORTA DÖNEM SONUÇLAR

Abstract

Amaç Eklem kıkırdağının yaş veya travmaya bağlı olarak zarar görmesine bağlı olarak hastanın hareketlerini kısıtlayıcı etki yapan koksartroz gelişebilmektedir. Koksartroz, kıkırdağın değiştirilmesi olan total kalça artroplasti ile tedavi edilmektedir. Bu çalışma ile, koksartrozlu hastalarda çimentosuz total kalça artroplastisinde (TKA) ameliyat sonrası sonuçlarla ilgili kısaorta dönem sonuçlarımız sunmak ve güncel literatür eşliğinde tartışmayı amaçladık. Gereç ve Yöntem Bu çalışmaya 1999 ve 2004 yılları arasında çimentosuz TKA tedavisi gören ve takibi yapılan, ortalama yaşı 54,1±9,6 olan 130 hasta (86 kadın, 44 erkek) dahil edilmiştir. TKA bağlı komplikasyonlar ve sonuçlar, hastaların takip dosyaları, laboratuvar testleri ve radyografilerine dayanarak gözden geçirilmiştir. Bulgular Preoperatif (41,75±9.62) ve post-operatif (90,44±7,51) modifiye Harris Kalça Skoru ölçümleri arasında istatistiksel olarak anlamlı fark bulunmuştur (p<0,001). On hastada (%7,6) ameliyat sırasında femur kırığı oluşmuştur. Anterior kalça ağrısı (26 hasta, %20,0) ve ekstremite boy farkı (20 hasta, %15,4) komplikasyonlar arasında en yaygınları olarak kaydedilmiştir. On üç hastada (%10,0) total kalça artroplastisi sonrası heterotrofik ossifikasyon gözlemlenmiş, ancak buna bağlı hareket kaybı gerçekleşmemiştir. Malpozisyon (7 hasta, %5,4), çıkık (3 hasta, %2,3), enfeksiyon (2 hasta, %1,5) ve derin venöz trombozu (1 hasta, %0,8) gözlemlenen diğer komplikasyonlar olmuştur. Asetabular komponentte gevşeme / migrasyon veya kalça hareketini kısıtlayan ağrı takip süresinde hiçbir hastada gözlenmemiştir. Sonuç Koksartrozlu hastalarda çimentosuz TKA ile kalça fonksiyonlarında düzelme elde edilmektedir. Bu yöntem ile tedavi edilecek koksartroz hastalarında, hastanın operasyon sonuçlarından memnun kalması, komplikasyonların en aza indirilmesi ve protezin uzun süre dayanması için detaylı bir ameliyat öncesi risk değerlendirmesinin yapılması gerekmektedir.

Keywords

• Koksartroz
• artroplasti
• total kalça protezi

CEMENTLESS TOTAL HIP ARTHROPLASTY: SHORT AND MID-TERM RESULTS

Abstract

Objective The destruction of the joint cartilage either by age or trauma can develop coxarthrosis limiting the motion of the patient, which is treated by the replacement of the whole joint with total hip arthroplasty. In this study, we aimed to report our short and mid-term results and discuss with the current literature on postoperative results of cementless total hip arthroplasty (THA) in patients with coxarthrosis. Material and Method One hundred thirty patients (86 female, 44 male) with a mean age of 54.1±9.6 years who underwent total hip arthroplasty with a cementless prosthesis included in the study. The outcomes and complications of the total hip arthroplasty were reviewed from patient’s counseling charts, laboratory tests and radiographs. retro Results There was a statistically significant difference between pre (41.75±9.62) and postoperative (90.44±7.51) mean modified Harris Hip Score measurements (p<0.001) indicating the successful outcome. Intraoperative femur fracture occurred in 10 patients (7.6%). Anterior thigh pain (26 patients, 20.0%) and extremity length difference (20 patients, 15.4%) were the most common complications observed. Although 13 patients (10.0%) had heterotopic ossification after total hip arthroplasty, none of the patients had limited motion associated with it. Malpositioning (7 patients, 5.4%), dislocation (3 patients, 2.3%), infection (2 patients, 1.5%) and deep venous thrombosis (1 patient, 0.8%) were among the other complications observed. There were no cases with acetabular cup migration or pain limiting hip movement. Conclusion The cementless THA provides improvement of hip function in patients with coxarthrosis. The preoperative risk assessment of the coxarthrosis patients is necessary to ensure patient’s satisfaction, minimize complications and provide long-term durability of the prosthesis.

Keywords

• Coxarthrosis
• arthroplasty
• total hip prosthesis

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