ÖN ÇAPRAZ BAĞ REKONSTRÜKSİYONU UYGULANMIŞ NORMAL VE OBEZ BİREYLERİN FONKSİYONEL SONUÇLARININ KARŞILAŞTIRILMASI

Year 2022, Volume: 29 Issue: 1, 127 - 132, 01.03.2022

Lokman Kehribar , Sina Coşkun

https://doi.org/10.17343/sdutfd.993186

Abstract

Amaç
Obezite, ortopedik cerrahide postoperatif klinik sonuçlara
etki eden bir klinik antitedir. Literatürdeki birçok
çalışma obezitenin ortopedik cerrahi üzerindeki etkilerini
ortaya koymuştur. Ön çapraz bağ (ÖÇB) yırtılması
genellikle genç ve aktif bireylerde görülür ve genellikle
cerrahi olarak tedavi edilir. Bu çalışmada obezitenin
ön çapraz bağ rekonstrüksiyonunun klinik sonuçları
üzerindeki etkisini araştırmak istedik.
Gereç ve Yöntem
Eylül 2012-Haziran 2016 yılları arasında opere edilen,
180 hasta retrospektif olarak değerlendirildi. Hastalar
vücut kitle indekslerine (VKİ) göre 2 gruba ayrıldı. Tüm
hastalar tek bir merkezde ve tek bir cerrah tarafından
ameliyat edildi. VKİ<25 kg/m² olan hastalar Grup 1'i
(n=113), VKİ>30 kg/m² olan hastalar Grup 2'yi (n=67)
oluşturdu. Hastaların yaş, cinsiyet, VKİ, ameliyat için
bekleme süresi, ameliyat öncesi ve ameliyat sonrası
Lysholm ve modifiye Cincinnati skorları bu iki grup
arasında karşılaştırıldı.
Bulgular
Gruplar arasında komplikasyon, takip süreleri, ameliyat
öncesi bekleme süresi, ameliyat öncesi ve sonrası
Lysholm skorları ve ameliyat sonrası modifiye Cincinnati
skorları açısından anlamlı fark bulunamadı. Ameliyat
öncesi modifiye Cincinnati skorlarında gruplar
arasında istatistiksel olarak anlamlı bir fark bulundu.
Komplikasyon oranları açısından iki grup arasında istatistiksel
olarak anlamlı bir fark saptanmadı.
Sonuç
ÖÇB rekonstrüksiyon cerrahisi normal VKİ'ye sahip
popülasyon ve VKİ'ye göre obez olan hastalarda
fonksiyonel diz skorları açısından benzer sonuçlara
sahiptir. Ancak bu sonuçları doğrulamak için daha
fazla klinik çalışmaya ve başka parametrelere ihtiyaç
vardır.

Keywords

Obezite, Ön çapraz bağ, Rekonstrüksiyon

COMPARISON OF FUNCTIONAL RESULTS OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN OBESE PATIENTS WITH NORMAL INDIVIDUALS

Abstract

Objective
Obesity is one of the most challenging diseases in
orthopedic surgery which directly affects the clinical
results of the operations. Many studies in the literature
demonstrated the effects of obesity on orthopedic
surgery. Anterior cruciate ligament (ACL) rupture
is commonly seen in young and active individuals
and generally treated surgically. In this study, we
had the intention to investigate the effect of obesity
on the clinical results of anterior cruciate ligament
reconstruction.
Material and Methods
180 patients were retrospectively evaluated whom
operated between September 2012 - June 2016. The
patients are divided into 2 groups according to their
body mass index (BMI). All patients were operated
on in a single center and by a single senior surgeon.
BMI<25 kg/m2 patients formed Group 1 (n=113),
BMI>30 kg/m2 patients formed the Group 2 (n=67).
Age, gender, BMI of the patients, waiting time for the
operation, preoperative and postoperative Lysholm
and modified Cincinnati scores were compared
between these two groups.A p-value less than 0.05
(typically ≤ 0.05) is statistically significant.
Results
There was no significant difference between the
groups in terms of complication, follow-up periods,
waiting time before operation, and pre-op and postop
Lysholm scores, and post-op modified Cincinnati
scores. A significant difference has been found
between the groups in pre-op modified Cincinnati
scores.
Conclusion
ACL reconstruction surgery has similar results in the
obese population compared to the normal weight
population in terms of functional further studies and
other parameters are needed to verify these results.

Keywords

Obesity, Anterior cruciate ligament, Reconstruction

References

• 1. Fukubayashi T, Torzilli P, Sherman M, Warren R. An in vitro biomechanical evaluation of anterior-posterior motion of the knee. Tibial displacement, rotation, and torque. The Journal of bone and joint surgery American volume. 1982;64(2):258-64.
• 2. Bisciotti GN, Chamari K, Cena E, Bisciotti A, Bisciotti A, Corsini A, et al. Anterior cruciate ligament injury risk factors in football. J Sports Med Phys Fitness. 2019;59(10):1724-38.
• 3. Sonesson S, Kvist J, Ardern C, Österberg A, Silbernagel KG. Psychological factors are important to return to pre-injury sport activity after anterior cruciate ligament reconstruction: expect and motivate to satisfy. Knee surgery, sports traumatology, arthroscopy. 2017;25(5):1375-84.
• 4. Wang LJ, Zeng N, Yan ZP, Li JT, Ni GX. Post-traumatic osteoarthritis following ACL injury. Arthritis research & therapy. 2020;22(1):57.
• 5. Costa-Paz M, Ayerza MA, Tanoira I, Astoul J, Muscolo DL. Spontaneous healing in complete ACL ruptures: a clinical and MRI study. Clinical Orthopaedics and Related Research®. 2012;470(4):979-85.
• 6. Bojicic KM, Beaulieu ML, Imaizumi Krieger DY, Ashton-Miller JA, Wojtys EM. Association between lateral posterior tibial slope, body mass index, and ACL injury risk. Orthopaedic journal of sports medicine. 2017;5(2):2325967116688664.
• 7. Lysholm J, Tegner Y. Knee injury rating scales. Acta orthopaedica. 2007;78(4):445-53.
• 8. Agel J, LaPrade RF. Assessment of differences between the modified Cincinnati and International Knee Documentation Committee patient outcome scores: a prospective study. The American journal of sports medicine. 2009;37(11):2151-7.
• 9. Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. Journal of athletic training. 1999;34(2):86.
• 10. Laxdal G, Kartus J, Ejerhed L, Sernert N, Magnusson L, Faxén E, et al. Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients. Arthroscopy: the journal of arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2005;21(8):958-64.
• 11. Thorburn A, Proietto J. Biological determinants of spontaneous physical activity. Obesity Reviews. 2000;1(2):87-94.
• 12. McCullough KA, Phelps KD, Spindler KP, Matava MJ, Dunn WR, Parker RD, et al. Return to high school–and college-level football after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) cohort study. The American journal of sports medicine. 2012;40(11):2523-9.
• 13. Almeida A, Valin MR, Ferreira R, Roveda G, Almeida NCd, Agostini AP. Evaluation of the results of arthroscopic ACL reconstruction with autogenous flexor tendons. Revista brasileira de ortopedia. 2010;45(4):404-8.
• 14. Adala R, Anand A, Kodikal G. Deep vein thrombosis and thromboprophylaxis in arthroscopic anterior cruciate ligament reconstruction. Indian J Orthop. 2011;45(5):450-3.
• 15. Cvetanovich GL, Chalmers PN, Verma NN, Cole BJ, Bach BR. Risk Factors for Short-term Complications of Anterior Cruciate Ligament Reconstruction in the United States. The American journal of sports medicine. 2016;44(3):618-24.
• 16. Rothman KJ. BMI-related errors in the measurement of obesity. International Journal of Obesity. 2008;32(3):S56-S9.