ÇİMENTOSUZ TOTAL KALÇA ARTROPLASTİSİ: KISA VE ORTA DÖNEM SONUÇLAR

Year 2021, Volume: 28 Issue: 2, 199 - 207, 15.06.2021

Deniz İpek , Fatih İbrahim Pesitlci Yalim Ateş Emrah Kovalak

https://doi.org/10.17343/sdutfd.533290

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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