Medial Kompartman Artrozlu HastalarınTedavisinde Yüksek Tibial Osteotomi ve UnikondilerDiz Artroplastisinin Karşılaştırılması

Yıl 2017, Cilt: 9 Sayı: 4, 235 - 249, 01.12.2017

Murat Aşcı , Orhan Balta M. Burtaç Eren Recep Kurnaz Taner Güneş

Öz

İzole medial kompartman artrozunun cerrahi
tedavisinde; unikompartmantal diz artroplastisi (UDP), yüksek tibial osteotomi
(YTO) ve bazen de total diz artroplastisi (TDP) alternatif yöntemlerdir. Bu
çalışmada benzer endikasyonları olan YTO ve UDP sonuçları klinik ve yaşam
kalitesi açısından karşılaştırmalı olarak değerlendirilmiştir. Temmuz 2003 ve
Şubat 2010 tarihleri arasında medialkompartman artrozu tanısı ile sirküler
eksternalfiksatörle yüksek tibialosteotomi ve unikondiler diz artroplastisi
yapılan toplam 47 hastanın 51 dizi çalışmaya alınmıştır. 31 hastanın (2 erkek,
29 kadın) 35 dizine sirküler eksternalfiksatörle YTO, 16 hastanın(16 kadın) 16
dizine UDP yapıldı. Hastalar; yaş, artroz derecesi, preoperatif ve postoperatif
diz KSS, HSS ve SF-36 skorları açısından karşılaştırıldı. Ameliyat öncesi ve
ameliyat sonrası değerler karşılaştırıldığında SF-36, HSS ve KSS skorlamaları
açısından anlamlı farklılık saptanmadı. Her iki grubun ameliyat sonrası
skorlarında anlamlı iyileşme elde edilirken, iyileşme miktarlarında iki grup
arasında anlamlı fark saptanmadı. UDP grubunda (YTO grubuna göre) SF-36’nın
ağrı ve emosyonel rol parametrelerinde daha hızlı ve daha fazla iyileşme elde
edildiği görüldü.

Klinik ve yaşam kalitesi
değerlendirmelerinin sonuçları dikkate alındığında medial kompartman osteoartritinin
tedavisinde her iki tekniğin de efektif ve memnuniyet verici olduğu
görülmüştür.

Anahtar Kelimeler

Gonartroz, Unikondiler diz protezi, tibial, osteotomi

Comparison of Unicondylar Knee Arthroplasty and High Tibial Osteotomy In Treatment of Medial Compartment Arthrosis

Öz

The surgical treatment alternatives for isolated
medial compartmental knee osteoarthritis are high tibial osteotomy (HTO),
unicompartmental knee arthroplasty (UKA) and rarely total knee arthroplasty
(TKA). In this study results of UKA and HTO are compared in regard to clinical
results and quality of life.

Between July 2003 and February 2010, 51 knees of 47
patients were operated for medial osteoarthritis of the knee. 35 knees of 31
patients (2 male and 29 female) underwent high tibial osteotomy using circular
external fixator and 16 knees of 16 patients (16 female) underwent
unicompartmental knee arthroplasty. The groups were compared according to age,
degree of arthrosis, preoperative and postoperative HSS, KSS and SF-36 scores.

There was no significant diffirence between the HTO
and UKA groups in regard to SF-36, HSS and KSS parameters in preoperative and
postoperative periods. Within each group there was significant increase in all
parameters in the postoperative period, but there was no diffirence between the
two groups. In UKA group the increase in pain and emotional role parameters of
SF-36 were more prominent and rapid.

In conclusion, in regard to clinical results and
quality of life results both treatment modalities were effective and
satisfactory in the treatment of medial compartmental knee osteoarthritis.

Anahtar Kelimeler

Gonarthrosis, Unicondylar Knee Prosthesis, Tibial, Osteotomy

Kaynakça

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