Tek seansta iki taraflı ile tek taraflı total diz artroplastisinin karşılaştırılması

Yıl 2014, Cilt: 48 Sayı: 2, 127 - 135, 17.04.2014

Yakup Ekinci Mithat Oner İbrahim Karaman İbrahim Halil Kafadar Mahmut Mutlu Mahmut Argun

https://doi.org/10.3944/AOTT.2014.3226

Öz

Amaç: Bu çalışmada tek seansta iki taraflı total diz artroplastisi (İTDA) ve tek taraflı total diz artroplastisinin (TTDA) morbidite, klinik ve radyolojik bulgular ile hayat kalitesi yönünden karşılaştırılması amaçlandı.

Çalışma planı: Kasım 2007 - Haziran 2012 tarihleri arasında tek seansta gerçekleştirilen 48 İTDA (46 kadın, 2 erkek; ortalama yaş: 64.00±8.31) ile 53 TTDA (45 kadın, 8 erkek; ortalama yaş: 64.40±7.45) hastası çalışmaya dahil edildi. Gruplar, komorbidite, komplikasyon, kan transfüzyonu, hastanede kalış süreleri, klinik ve radyolojik (AKSS) bulgular ve hayat kalitesi (SF-36) yönünden değerlendirildi.

Bulgular: İkisi cerrahi sonrası ilk 30 gün içinde olmak üzere, İTDA grubundan 3 hastada, TTDA grubundan 1 hastada pulmoner emboli gelişmesi nedeniyle hastaların yoğun bakım servisinde takibi yapıldı. İTDA grubundan 1 hasta erken dönemde; yine İTDA grubundan 1 hasta ile TTDA grubundan 1 hasta da bir yıl içinde yaşamlarını yitirdi. Hastaların hastanede kaldığı süreler, cerrahi sırasındaki kan transfüzyon miktarları ve mortalite bulguları TTDA lehine, revizyon bulguları İTDA lehine istatistiksel olarak anlamlı bulundu (p<0.05). Diz ve fonksiyon puanları ile SF-36’nın sekiz parametresinde tüm hastalarda artış görülürken, iki grup arasında anlamlı bir fark bulunmadı (p>0.05).

Çıkarımlar: Yetmiş yaş altında, ek hastalığı olmayan, uyumlu hasta seçimi ile tek seansta İTDA’nın uygulanması bir seçenek olarak düşünülebilir.

Anahtar Kelimeler

Komplikasyon; tek seansta iki taraflı; tek taraflı; total diz artroplastisi.

Comparison of simultaneous bilateral with unilateral total knee arthroplasty

Öz

Objective: The aim of this study was to compare simultaneous bilateral total knee arthroplasty (BTKA) and unilateral total knee arthroplasty (UTKA) in terms of morbidity, clinical and radiological findings and quality of life.

Methods: The study included 48 simultaneous BTKAs (46 females, 2 males; mean age: 64.00±8.31 years) and 53 UTKAs (46 females, 7 males; mean age: 64.40±7.45 years) performed between November 2007 and June 2012. Groups were compared with respect to comorbidity, complications, blood transfusion, hospital stay, clinical and radiological (American Knee Society Score) findings and quality of life (SF-36).

Results: Three patients in the BTKA group and 1 in the UTKA group required intensive care admission due to pulmonary embolism; 2 cases occurred within the first postoperative 30 days. One BTKA patient died in the early postoperative period and 1 patient from the BTKA and 1 from the UTKA group died within 1 year. Hospital stay, perioperative blood transfusion parameters and mortality rates were significantly different in favor of UTKA and revision operation rates in favor of BTKA (p<0.05). All patients had improved knee and function scores and SF-36 scores. However, there was no significant difference between the groups (p>0.05).

Conclusion: Simultaneous BTKA should be considered in selected patients under 70 years of age with good compliance and no comorbid disease.

Anahtar Kelimeler

Complication, simultaneous bilateral, total knee arthroplasty, unilateral

Kaynakça

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