Kısıtlayıcı asetabular komponent kullanmak kalça eklem hareket açıklığını gerçekten azaltır mı?

Abstract

Amaç: Kısıtlayıcı asetabular insertler, instabilitenin cerrahi tedavisinde sıklıkla kullanılmaktadır. Bununla birlikte, gevşeme sıklığını artıracağı ve kalça eklem hareket açıklığını azaltacağı endişesi ile cerrahlar arasında daha az tercih edilmektedir. Bu çalışmanın amacı, kısıtlayıcı asetabular komponent kullanımının kalça eklem hareket açıklığı ve fonksiyonel sonuçlar üzerindeki etkisinin incelenmesidir Gereç ve Yöntemler: Revizyon kalça artroplastisi uygulanan 28 hasta çalışmaya dahil edildi. Hastalar kullanılan insert tipine göre kısıtlayıcı ve kısıtlayıcı olmayan şeklinde iki gruba ayrıldı. Ortalama takip süresi kısıtlayıcı grupta 61±7 (50-74) ay, kısıtlayıcı olmayan grupta 59±7 (50-72) aydı.Kalça eklem hareket açıklıkları ve harris kalça skorları ameliyat öncesi ve sonrası son kontrolde kaydedildi. Bulgular: Ortalama fleksiyon, abdüksiyon, addüksiyon, dış rotasyon ve iç rotasyon değerleri kısıtlayıcı grupta (n=15) sırası ile 78°±15°, 43°±4°, 28°±3°, 30°±7°,19°±8° iken, kısıtlayıcı olmayan grupta (n=13) 75°±14°, 40°±6°, 26°±5°, 30°±12°, 17°±6° idi. Gruplar arasındaki fark istatistiksel olarak anlamlı değildi (p>0.05). Harris kalça skorları her iki grupta da ameliyat öncesine göre anlamlı artış gösterdi, gruplar arasında anlamlı farklılık yoktu (p>0.05). Sonuç: Bu çalışmanın bulguları, kısıtlayıcı asetabular insert kullanılan hastalardaki kalça eklem hareket açıklıkları ve fonksiyonel sonuçların, orta dönemde, kısıtlayıcı olmayanlara göre daha az olmadığını göstermiştir.

Keywords

• eklem hareket açıklığı
• total kalça artroplastisi
• eklem instabilitesi

Does using constrained acetabular component really limit hip range of motion?

Abstract

Aim: In surgical treatment of instability, constrained acetabular inserts are frequently used in hip arthroplasty. However the reasons why surgeons avoid constrained acetabular components are the concern of an increased rate of loosening possibly due to impingement and the concern of decreased range of motion. This study aims to investigate the influence of constrained acetabular insert usage on hip range of motions and functional results. Material and Methods: Twenty-eight patients who needed revision hip arthroplasty were included. Patients were divided into two groups according to acetabular insert used in surgery (constrained and non-constrained). Mean follow-up period was 61±7 months (range, 50-74) in constrained group and 59±7 (range, 50-72) in non-constrained group. Hip range of motion and harris hip scores were recorded pre-operatively and at final follow-up. Results: The final avarage flexion, abduction, adduction, external rotation and internal rotation was respectively 78°±15°, 43°±4°, 28°±3°, 30°±7°,19°±8° in constrained group (n=15) and 75°±14°, 40°±6°, 26°±5°, 30°±12°, 17°±6° in non-constrained group (n=13). The difference between groups was not statistically significant. Harris hip score increased in both groups and there was no significant difference between groups (p=0.730). Conclusion: Findings of this mid term study showed that hip range of motions and functional results in patients with constrained acetabular inserts are not inferior than the patients with non-constrained inserts.

Keywords

• articular range of motion
• total hip arthroplasty
• joint instability

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