Gonartrozda Klinik ve Radyolojik Uyum

Yıl 2021, Cilt: 13 Sayı: 3, 136 - 144, 26.12.2021

Mesut Tahta Tahir Öztürk Fırat Erpala Eyüp Çağatay Zengin

Öz

Amaç: Bu calismanin amaci gonartrozu olan hastalarda semptomlar ve radyolojik derecelendirme sistemi arasindaki ilişkiyi degerlendirmektir.
Hastalar ve yöntem: Ocak 2012 ile Haziran 2013 tarihleri arasında primer gonartrozu olan hastalar prospektif olarak değerlendirildi. Kriterleri karşılayan 724 hastanın 512'si (%70,7) kadın, 212'si (%29,3) erkekti.Ortalama yaş 56 (35-79) yıl idi. Klinik değerlendirme için WOMAC skorlaması kullanıldı. Her iki diz yarı fleksiyonda ayakta yük alırken ön-arka, yan ve patella tanjansiyel röntgenleri çekildi ve Kellgren – Lawrence sınıflamasına göre derecelendirme yapıldı. Hastaların WOMAC skorları radyolojik derecelerine göre düzenlendi. Derece 1 derece 2 ile, derece 2 derece 3 ile ve derece 3 derece 4 ile karşılaştırıldı.Ayrıca ek görüntüleme çalışmaları ve önerilen tedavi seçenekleri not edildikten sonra Kellgren – Lawrence derecelerine göre dağılım hesaplandı.
Bulgular: Hastaların 89'u (%12.2) evre 1, 208'i (%28.7) evre 2, 256'sı (%35.3) evre 3 ve 171'i (%23.8) evre 4 idi. WOMAC puanlarına göre 1. ve 2. sınıf arasındaki fark istatistiksel olarak anlamlıydı (p=0.003). 2. ve 3. derece arasındaki fark anlamlı değildi (p=0.071). Aynı şekilde 3. ve 4. derece arasındaki fark anlamlı değildi (p=0.097). Ek görüntüleme çalışmaları MRI, tomografi ve sintigrafi olup; sunulan tedavi seçenekleri konservatif tedavi, artroskopi, tibial osteotomi, unikondiler diz artroplastisi ve total diz artroplastisi idi.
Sonuç: Tedavide karar vermede röntgen ve evreleme yeterli görünmemektedir. Ayrıca semptomlar ve radyolojik bulgular da dikkate alınmalıdır.

Anahtar Kelimeler

Gonartroz, klinik sonuçlar, görüntüleme

Clinical and Radiological Compatibility in Gonarthrosis

Öz

Objective: The aim of this study was to evaluate the relationship between symptoms and radiologic grading system.
Patients and Methods: Patients with primary gonarthrosis between January 2012 and June 2013 were evaluated prospectively. 512 (70.7%) of 724 patients were women and 212 (29.3%) were men, who meet the criteria. Mean age was 56 (35-79). WOMAC total score was used for clinical evaluation. Both knees semiflexion weight bearing anteroposterior, lateral and patella tangential X-rays were obtained, then grading was made according to Kellgren – Lawrence classification. WOMAC scores of patients were arranged according to their radiologic grades. Grade 1 was compared with grade 2, grade 2 with 3 and grade 3 with 4. Also additional imaging studies and offered treatment choices were noted, then distribution according to Kellgren – Lawrence grades was calculated.
Results: 89 (%12.2) of patients were grade 1, 208 (%28.7) of patients were grade 2, 256 (%35.3) of patients were grade 3 and 171 (%23.8) of patients were grade 4. There was a significant difference between grade 1 and 2 according to WOMAC scores (p=0.003). The difference between grade 2 and 3 was not significant (p=0.071). The difference between grade 3 and 4 was not significant (p=0.097). Additional imaging studies were MRI, tomography and scintigraphy. Offered treatment options were non operative, arthroscopy, tibial osteotomy, unicondylar knee arthroplasty and total knee arthroplasty.

Conclusion: X-rays and staging seems to be not enough for decision making in treatment. Also symptoms and radiological findings should be considered.

Anahtar Kelimeler

gonarthrosis, clinical results, imaging

Kaynakça

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