Kalça artroplastisi uygulanan hastalarda koksartroz etiyolojisi

Öz

Amaç: Total kalça protezi uygulanan hastalarda koksartroz etiyolojisini incelemeyi amaçladık. Çalışma planı: 2001-2012 yılları arasında İstanbul’da iki ayrı klinikte total kalça protezi uygulanmış 886 hastanın 965 kalçasının kayıtları incelendi. Her hastanın ameliyat öncesi ve sonrası grafileri ve yaş, cinsiyet, taraf bilgileri değerlendirildi. Bulgular 2 ortopedi uzmanı tarafından bağımsız olarak değerlendirilerek muhtemel etiyolojik neden belirlendi. Bulgular: Hastaların 684’ü kadın, 202’si erkek idi. Yaş ortalaması kadınlarda 62.7±14.3 (dağılım: 16-91), erkeklerde ise 58.8±17.1 (dağılım: 25-91) olarak bulundu. Hastaların %52.1’inin sağ, %39’unun sol ve %8.9’unun her iki kalçası opere edilmişti. Kadın hastaların %36.2’sinde primer koksartroz varken, etiyoloji hastaların %43.5’inde gelişimsel kalça displazisine (GKD), %10’unda avasküler nekroza (AVN), %7’sinde romatizmal hastalıklara, %5’inde femur başı epifiz kaymasına (FBEK), %3.9’unda posttravmatik koksartroza (PTK), %1.9’inde patolojik koksartroza ve %1.7’sinde Perthes sekeline bağlıydı. Erkekler hastaların %24.4’ünde primer koksartroz varken, etiyoloji hastaların %21’inde AVN’ye, %17.6’sında GKD’ye, %16.8’inde PTK’ye, %10.9’unda romatizmal hastalıklara, %4.2’sinde Perthes sekeline, %2.5’inde FBEK’ye ve %2.5’inde patolojik koksartroza bağlandı. Tüm popülasyonda ise en sık etiyolojik faktör %37.1 ile GKD olarak bulundu. Çıkarımlar: İncelenen hasta popülasyonunun heterojenitesine rağmen çalışmamız ülkemizdeki koksartroz etiyolojisi dağılımı hakkında genel bir bilgi vermektedir. Halen displaziye bağlı koksartroz en sık etiyolojik faktör olarak görülmektedir.

Anahtar Kelimeler

• Displazi; gelişimsel kalça displazisi; koksartroz; osteoartrit; total kalça protezi.

Etiology of coxarthrosis in patients with total hip replacement

Abstract

Objective: We aimed to find out the distribution of etiological factors in patients who had total hip replacement for coxarthrosis.
Methods: The medical records of the 965 hips of 886 patients operated with total hip replacement between 2001 and 2012 in two separate arthroplasty clinics were analyzed by two separate senior surgeons. Each patient’s pre- and postoperative X-rays and demographic data such as gender, age, side and probable etiologic factors were noted.
Results: Six hundred and eighty-four patients were women and 202 were men. The mean age were 62.7±14.3 (range: 16 to 91) in women, 58.8±17.1 (range: 25 to 91) in men. 52.1% of the surgeries were performed on the right side, 39% on the left, and 8.9% bilaterally. In women 36.2% of the cases were primary coxarthrosis, while the etiology was developmental dysplasia of the hip (DDH) in 43.5% of the cases, avascular necrosis in 10%, romatoid diseases in 7%, slipped capital femoral epiphysis in 5%, posttraumatic coxarthrosis in 3.9%, pathologic coxarthrosis in 1.9%, and Perthes sequel in 1.7%. In men, 24.4% of the cases were primary coxarthrosis, while the etiology was avascular necrosis in 21% of the cases, DDH in 17.6%, posttraumatic coxarthrosis in 16.8%, romatoid diseases in 10.9%, Perthes sequel in 4.2%, slipped capital femoral epiphysis in 2.5%, and pathologic coxarthrosis in 2.5%. The most common etiologic factor was DDH with a rate of 37.1%.
Conclusion: Despite the heterogeneity of our study population, our results may reflect the distribution of coxarthrosis etiologies in Turkey. Developmental dysplasia of the hip appears to be the most frequent cause of coxarthrosis among the patients undergoing total hip replacement.

Keywords

• Coxarthrosis
• developmental dysplasia of the hip
• dysplasia
• osteoarthritis
• total hip replacement

Kaynakça

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