Türk toplumunda medial tibial platonun morfometrisi ve unikondiler diz protezi tibial komponentleriyle olan ilişkisi

Öz

Amaç: Bu çalışmanın amacı Türk hastaların tibial rezeksiyon alanlarının ölçümünü yapmak ve bu ölçümleri günümüzde kullanılan tibial implantların boyutları ile karşılaştırmak idi.

Çalışma planı: İki yüz altmış hastanın MR görüntülerinde unikondilerdiz artroplastisinde (UDA)rezeksiyonu yapılan medial tibial platonun 7 farklı boyutunun ve Türkiye’de en fazla kullanılan UDA implantlarının ölçümü yapıldı. İstatistiksel analiz için SPSS yazılımı kullanılarak Student’s t-test, ANOVA, ki-kare ve Pearson korelasyon katsayısı testlerinden yararlanıldı.

Bulgular: Türk toplumunun dizlerindeki anteroposterior ve tibial platonun en geniş mediolateral boyutları Accuris ve Mitus implantlarına göre Oxford ve Zuk implantlarında nispeten daha yaklaşık bulundu (p<0.001). Merkez mediolateral boyut ile en geniş mediolateral boyut arasındaki mesafe erkeklerde 2.4 (dağılım: 0-6.3) mm, kadınlarda 2.6 (dağılım: 0-6.3) mm olarak bulundu. Bu ölçümler bize maksimum mediolateral boyutun, olgularımızın çoğunda (260 ölçümün 202’sinde) merkez mediolateral boyutun posteriorunda bulunduğunu gösterdi. Bu sonuçlar, rezeke edilen medial tibial kondilin anteroposterior ölçümlerinin asimetrik olduğuna işaret etmekteydi.

Çıkarımlar: Batı ve Asya toplumlarının antropometrik ölçümlerine göre tasarlanan tibial implantlar Türk toplumunun ihtiyaçlarını tam olarak karşılamamaktadır. En iyi uyum için farklı toplumlara yönelik farklı UDA implantlarının tasarlanması gerekmektedir.

Anahtar Kelimeler

• Protez; tibial implant; Türk toplumu; unikondiler diz artroplastisi.

Morphometry of the medial tibial plateau in Turkish knees: correlation to the current tibial components of unicompartmental knee arthroplasty

Abstract

Objective: The objective of this study was to measure the resected surfaces of the tibia in knees of Turkish patients and to compare these measurements with the dimensions of tibial implants in current use.

Methods: We made measurements of seven different dimensions of the medial tibial plateau at the virtual resection level for unicompartmental knee arthroplasty (UKA) on MRIs of 260 patients and the most commonly used four UKA implants in Turkey. Statistical analysis was performed by using Student’s t-test, analysis of variance (ANOVA), chi-square test and Pearson’s correlation coefficient by using SPSS software.

Results: The anteroposterior and widest mediolateral dimensions of the tibial plateau of Turkish knees were found relatively more approximate to the dimensions of Oxford and Zuk prostheses compared to that of Accuris and Mitus (p<0.001). The distance between the central mediolateral dimension and the widest mediolateral dimension was 2.4 (range: 0-6.3) mm in males and 2.6 (range: 0-6.2) mm in females. The maximum mediolateral dimension was found posterior to the central mediolateral dimension in the majority (202 out of 260) of cases. These findings point towards the asymmetry in the AP halves of the resected medial tibial condyle.

Conclusion: Tibial components designed according to anthropometric measurements based on both Western and Asian populations do not perfectly meet the requirements of Turkish population. Designing different UKA prostheses for different populations are required for best fit.

Keywords

• Prosthesis
• tibial implant
• Turkish population
• unicondylar knee arthroplasty

Kaynakça

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