Osteoartritli dizlerde menisküs yaralanmalarının artroskopik karakteristikleri

Yıl 2014, Cilt: 48 Sayı: 3, 276 - 282, 30.05.2014

Jinglong Li Liangyu Lu Wenhui Zhu Dongliang Shi Ke Zhan Yubin Wang

https://doi.org/10.3944/AOTT.2014.3167

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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