Osteoartritli dizlerde menisküs yaralanmalarının artroskopik karakteristikleri

Öz

Amaç:Bu çalışmanın amacı osteoartritli dizlerde menisküs yaralanmalarının artroskopik karakteristiklerini incelemek ve uygulanacak cerrahi yaklaşımdaki önemini saptamaktı.

Çalışma planı: Dört orijinal tipteki menisküs yaralanmaları tanımlandı. Çalışmaya katılan 87 olgunun 12’si Tip 1, 26’sı Tip 2, 35’i Tip 3 ve 14’ü Tip 4 menisküs yaralanmalarıydı. Tip 1 olguların 5’inin menisküsü sütür ile onarılırken, 7 olguda kısmi rezeksiyon; Tip 2 olguların 22’sinde kısmi rezeksiyon, 4’ünde subtotal rezeksiyon; Tip 3 olguların 2’sinde debridman, 8’inde kısmi rezeksiyon, 19’unda subtotal rezeksiyon, 6’sında total rezeksiyon; ve Tip 4 olguların 3’ünde subtotal rezeksiyon, 11’inde ise total rezeksiyon yapıldı. Hastalar Lysholm, görsel analog skala ve Kellgren-Lawrence skorları ve kıkırdak lezyonlarının evrelerine göre değerlendirildiler.

Bulgular: Takip süresinin ortalama 26 (dağılım: 8-51) ay olduğu kaydedildi. On üç olguda yorgunluk sonrası eklemde şişlik ve ağrı gözlendi. Bir Tip 3 ve bir Tip 4 olguda kilitlenme semptomu mevcuttu. Tip 3 olguların birinde ve Tip 4 olguların ikisinde eklem fleksiyonu 20° ile kısıtlıydı. İki Tip 2 ve iki Tip 4 olguya cerrahi sonrası 2 yıl ila 3 yıl 2 ay sonrası dönemde total diz artroplastisi yapıldı.

Çıkarımlar: Osteoartritli dizlerde menisküs yaralanmalarının sınıflandırması, artroskopi cerrahisine rehberlik etmesi amacıyla ve diz osteoartritinde minimal invaziv cerrahinin tedavi edici etkisini geliştirmek üzere tasarlanmıştır.

Anahtar Kelimeler

• Artroskopik karakteristik; diz; menisküs; minimal invaziv cerrahi; osteoartrit.

Arthroscopic characteristics of meniscal injuries in osteoarthritic knees

Öz

Objective:The aim of this study was to investigate the arthroscopic characteristics of meniscal injuries in osteoarthritic knees and explore their significance in the selection of surgical approach.

Methods: Four original types of meniscal injuries were defined. The study included 87 cases; 12 Type 1, 26 Type 2, 35 Type 3 and 14 in Type 4 meniscal injuries. For Type 1 injuries, 5 cases underwent meniscal suture repair and 7 cases partial meniscal resection. Partial meniscal resection was performed in 22 cases and subtotal resection in 4 cases of Type 2 injury. For Type 3 injury, meniscal debridement was performed in 2, partial resection in 8, subtotal resection in 19 and total resection in 6 cases. For Type 4 injury, 3 cases underwent subtotal resection and 11 underwent total resection. Patients were evaluated with the Lysholm, visual analog scale, and Kellgren-Lawrence scale scores and cartilage lesions stages.

Results: Mean follow-up period was 26 (range: 8 to 51) months. Joint swelling or pain was present in 13 cases after fatigue. Twist lock symptom was observed in one Type 3 injury and one Type 4 injury. Joint flexion was limited to 20° in one Type 3 injury and two Type 4 injuries. Total knee joint replacement was performed in two Type 2 and two Type 4 injuries 2 to 3 years and 2 months after surgery.

Conclusion: The classification of meniscal injuries in osteoarthritic knees was designed to guide arthroscopic surgery and improve the therapeutic efficacy of minimally invasive surgery for knee osteoarthritis.

Anahtar Kelimeler

• Arthroscopic characteristic
• knee
• meniscus
• minimally invasive surgery
• osteoarthritis

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