Total Kalça Artroplastisi Revizyonu: Son Yirmi Yılda Nedenler ve Değişimler?

Yıl 2025, Cilt: 6 Sayı: 3, 288 - 294, 28.09.2025

Evrim Duman , Mehmet Çıtak , Osman Yağız Atlı , Burhan Kurtuluş

https://doi.org/10.47482/acmr.1675820

Öz

Giriş: Total kalça artroplastisi revizyonu, primer total kalça artroplastisine göre daha zor ve daha az başarılı bir girişimdir. Revizyon cerrahisi daha fazla cerrahi süre, daha fazla kan kaybı ve primer cerrahiye kıyasla daha yüksek komplikasyon demektir. Revizyon nedenleri arasında komponentlerin ağrılı gevşemesi, implant yetmezliği, çıkıklar, enfeksiyonlar ve periprotesik kırıklar yer alır. Cerrahi teknik, implant tasarımı ve kemik kaybı yönetimindeki ilerlemeler, cerrahların total kalça artroplastisi revizyonunun zorluklarının üstesinden gelmelerine ve revizyon cerrahisi geçiren hastalar için sonuçları iyileştirmelerine yardımcı olmuştur.
Yöntem: Bu retrospektif çalışma, yirmi yıl arayla total kalça artroplastisi revizyonu yapılan iki grup hastayı incelemiştir. Hastaların yaş, cinsiyet, primer ve revizyon total kalça artroplastisi geçirdikleri tarih, revizyon nedenleri ve ayrıntılı ameliyat bulguları olmak üzere verileri kaydedildi.
Bulgular: Her iki grupta da demografik özellikler benzerdi, ancak ortalama yaş farklıydı - ilk grupta ortalama yaş 55,4 yıl iken, ikinci grupta 63,5 yıldı. Her iki grupta da revizyonun en yaygın nedeni aseptik gevşeme iken çıkıklar, enfeksiyon ve periprotesik kırıklar diğer nedenler arsındaydı.
Sonuç: Veriler, çıkıkların zaman içinde azalan bir oranda görüldüğünü destekliyor. Bu azalma muhtemelen cerrahi tekniğin geliştirilmesine, implant tasarımındaki yeniliklere ve “constraint liner” kullanımına bağlanabilir. Bununla birlikte, enfeksiyon hala önemli bir komplikasyon olarak önemini korumaktadır.

Anahtar Kelimeler

Revizyon Cerrahisi , Total Kalça Artroplastisi , Protez Gevşemesi

Total Hip Arthroplasty Revision: Causes and Changes Over the Past Two Decades?

Öz

Background: The revision of total hip arthroplasty (THA) is more challenging and has less successful outcomes than primary THA. Revision surgery takes more time, results in more blood loss, and has higher complication risks compared to primary surgery. Common reasons for revision include painful component loosening, implant failure, dislocations, infections, and periprosthetic fractures. Advances in surgical methods, implant designs, and bone loss management have assisted surgeons in addressing the challenges of revision THA and improving outcomes for patients undergoing this complex procedure.
Methods: In this retrospective cohort study, the THA revision surgeries of two groups conducted two decades apart were evaluated. All patient data, including age, gender, date of primary THA, date of revision surgery, reason for revision, and detailed intraoperative findings were recorded.
Results: The demographics were similar in both groups, but the average age was statistically significantly different (p<0.001). In the first group, it was 55.4 years, while in the second group, it was 63.5 years. The most common reason for revision in both groups was aseptic loosening. Infection, dislocation, and periprosthetic fractures were other reasons for revision.
Conclusion: The data indicate that dislocations have constituted a decreasing proportion of revision causes over time, likely attributable to improvements in surgical techniques, advancements in implant design, and the utilization of constrained liners. Nonetheless, infection persists as a significant challenge.

Anahtar Kelimeler

Revision Surgery , Total Hip Arthroplasty , Prosthesis Loosening.

Etik Beyan

Our study was approved by the Ethics Committee of Ankara Etlik City Hospital (Date: 12.03.2025, No: AEŞH-BADEK-2025-243).

Kaynakça

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