Koksartrozda uygulanan çimentosuz total kalça protezinin klinik sonuçları

Yıl 2020, Cilt: 45 Sayı: 2, 731 - 737, 30.06.2020

Melih Bağır Ahmet Yılmaz

https://doi.org/10.17826/cumj.686836

Öz

Amaç: Total kalça protezi uygulamalarında çimentolu, çimentosuz ve hibrid tespit yöntemlerinin sonuçları tartışılmaya devam etmektedir. Çalışmamızın amacı, çimentosuz total kalça protezi olgularımızın klinik ve radyolojik sonuçlarını literatür eşliğinde değerlendirmektir.
Gereç ve Yöntem: Çalışmamızda çimentosuz total kalça protezi uygulanan olgular geriye dönük olarak değerlendirildi. En az 1 yıllık takibi olan 80 hastanın 95 kalçası çalışmaya dahil edildi. Klinik değerlendirmede Harris kalça skoru (HKS) kullanıldı. Radyolojik değerlendirmede ise komponentlerin malpozisyonuna ve gevşemeye bakıldı. Ayrıca hastalar heterotopik ossifikasyon, dislokasyon ve diğer komplikasyonlar açısından incelendi.
Bulgular: Hastaların 47 (%58.7)’si kadın, 33 (%41.3)’ü erkekti. Olguların yaş ortalaması 52.312.8 idi. Otuz altı (%45) hastada sağ kalça, 29 (%36) hastada sol kalça ve 15 (%18.7) hastada bilateral kalça protezi uygulandı. Cerrahi yaklaşım olarak, hastaların 74 (%77.9)’ünde posterolateral, 21 (%22.1)’inde anterolateral insizyon kullanıldı. Ortalama takip süresi 3818.8 ay idi. Hastaların ameliyat öncesi ve son kontroldeki toplam Harris kalça skorları sırasıyla 28.5210.93 ve 87.097.03 idi. Radyolojik değerlendirmede hastaların 12 (%12.6)’sinde asetabuler malpozisyon tespit edildi. Hastaların 8 (%8.4)’inde intraoperatif kırık saptandı.
Sonuç: Çimentosuz total kalça protezi uyguladığımız hastalarımızda, kısa ve orta dönemde Harris kalça skoru değerlendirmesine göre başarılı klinik sonuçlar elde edilmiştir. Çimentosuz tespitte erken dönemde sıkı stabilizasyon sağlanır, fakat intraoperatif kırık ve asetabuler komponentlerin malpozisyonu açısından dikkatli olunmalıdır.

Anahtar Kelimeler

Osteoartrit, kalça, artroplasti

Clinical outcomes of cementless total hip replacement in coxarthrosis

Öz

Purpose: The outcomes of cemented, cementless and hybrid fixation options in total hip replacement are still controversial. The aim of our study is to evaluate the clinical and radiological results of our cementless total hip replacement cases compared with the literature.
Materials and Methods: We evaluated 80 patients’ 95 cementless total hip arthroplasties retrospectively. The minmum follow up periodwas 12 months. We used the Harris Hip Score (HHS) for clinical evaluation. We evaluated malposition, aseptic loosening, heterotopic ossification, dislocation and other complications by direct radiography.
Results: Forty seven (58.7%) of the patients were female and 33 were male (41.3%). Mean age of the patients was 52.312.8 years. Thirtysix (45%) of the patients were operated in the right hip, 29 (36%) of the patients were operated in the left hip and 15 (18.7%) of the patients were operated bilaterally. Posterolateral incision was used in 74 (77.9%) patients and posterolateral incision was used in 21 (22.1%) patients. Mean follow up was 3818.8 months. Total Harris hip scores of the patients before and after surgery were 28.5210.93 and 87.097.03, respectively. There was acetabular malposition in 12 patients. Eight patients had intraoperative fractures.
Conclusion: Cementless total hip arthroplasty provided good clinical outcomes in Harris Hip Score evaluation in short to-medium-term. Rigid cementless fixation in early period can be achieved but, caution is advised against intraoperative fracture and acetabular component malposition.

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