JOINT LINE CHANGES AND PATELLA BAJA INFLUENCE CLINICAL OUTCOMES OF REVISION TOTAL KNEE ARTHROPLASTY

Yıl 2024, , 113 - 120, 27.03.2024

Mehmet Ekinci , Fatih Şentürk , Koray Şahin , Şahin Karalar , Yavuz Sağlam , Cengiz Şen

https://doi.org/10.26650/IUITFD.1394886

Öz

Objective: The purpose of our study was to determine joint line (JL), posterior condylar offset ratio (PCOR), and patellar height alterations following revision total knee arthroplasty (RTKA) and evaluate the functional results according to the critical limits defined in the literature.
Material and Method: Fifty-one patients with a minimum of two years of follow-up were retrospectively reviewed. Demographic data and operative reports were evaluated. Joint line change was measured according to the method of Figgie. Patellar height was measured using the Insall–Salvati Index and the Blackburn–Peel Index. The effect of JL, patellar height alteration, and PCOR on functional outcomes was analyzed using the Knee Society Score (KSS), knee range of motion (ROM), SF-12, and visual analog scale score as functional results.
Result: Patients whose joint lines were not reconstructed had a lower KSS than those whose JLs were restored in accordance with the crucial limit of 5 mm. The other functional results were similar. Functional outcomes were similar between patients with PCORs under 0.44 and those with PCORs higher than 0.44. There was also no significant difference in functional results for the group of patients whose PCOR was lower than 0.5 and those whose PCOR was higher than 0.5. The patients with patella baja had significantly lower knee ROMs, KSS, and SF-12 PCS scores than those without patella baja (p:0.012,p:0.03, and p:0.01, respectively).
Conclusion: In this study, joint line change >5 mm and patella baja negatively affected clinical outcomes after RTKA.

Anahtar Kelimeler

Revision knee arthroplasty, joint line, prognostic factors, functional results, patella baja

EKLEM ÇİZGİSİ DEĞİŞİKLİĞİ VE AŞAĞI YERLEŞİMLİ PATELLA REVİZYON TOTAL DİZ PROTEZİ KLİNİK SONUÇLARINI ETKİLEMEKTEDİR

Öz

Amaç: Çalışmamızın amacı revizyon total diz artroplastisi (RTKA) sonrası eklem hattı (JL), posterior kondiler ofset oranı (PCOR) ve patellar yükseklik değişikliklerini belirlemek ve fonksiyonel sonuçlara etkisini literatürde tanımlanan kritik sınırlara göre değerlendirmektir.
Gereç ve Yöntem: Takip süresi en az iki yıl olan 51 hasta retrospektif olarak incelendi. Demografik veriler ve ameliyat raporları değerlendirildi. JL değişimi Figgie'nin yöntemine göre ölçüldü. Patellar yükseklik hem Insall-Salvati İndeksi hem de Blackburn-Peel İndeksi kullanılarak ölçüldü. JL, patellar yükseklik değişikliği ve PCOR'un fonksiyonel sonuçlar üzerindeki etkisi, fonksiyonel sonuçlar olarak Knee Society Score (KSS), diz hareket açıklığı (ROM), SF-12 ve visüel analog skala skoru kullanılarak analiz edildi.
Bulgular: JL'si kritik sınır olan 5 mm'ye göre yeniden yapılan hastaların KSS'larının, eklem seviyesi rekonstrükte edilemeyen hastalara göre anlamlı derecede yüksek olduğu belirlendi. Diğer fonksiyonel sonuçlar benzerdi. PCOR'u 0,44'ün altında olan hasta grubu ile PCOR'u 0,44'ün üzerinde olan hasta grubunun fonksiyonel sonuçlar benzerdi. Hem PCOR'u 0,5'in altında olan hasta grubu hem de PCOR'u 0,5'in üzerinde olan hasta grubu arasında fonksiyonel sonuçlarda da anlamlı fark yoktu. Patella baja'lı hastaların diz ROM'ları, KSS ve SF-12 PCS skorları patella baja'sız hastalara göre anlamlı derecede düşüktü (sırasıyla p:0,012, p:0,03 ve p:0,01).
Sonuç: Bu çalışmada RTKA sonrası >5 mm eklem seviyesi değişikliği ve patella baja gelişmesinin fonksiyonel sonuçlara olumsuz etkisi bulunduğu tespit edilmiştir.

Anahtar Kelimeler

Revizyon total diz protezi, eklem seviyesi, prognostik faktörler, fonksiyonel sonuçlar, patella baja

Kaynakça

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