DOES PROXIMAL TIBIOFIBULAR JOINT MEDIATED PAIN MAKE PATIENTS UNHAPPY AFTER TOTAL KNEE ARTHROPLASTY IN KNEES WITH PRIMARY OSTEOARTHRITIS AND VARUS MALALIGNMENT?

Yıl 2017, Cilt: 18 Sayı: 4, 136 - 140, 16.10.2017

Andaç Akbaş Hakan Boya Özal Özcan , Gökhan Maralcan

https://doi.org/10.18229/kocatepetip.368673

Öz

OBJECTIVE: Presence of a clinical correlation has not
been demonstrated between tibiofemoral joint (TFJ) and
proximal tibiofibular joint (PTFJ) in knees with severe osteoarthritis.
The purpose of this retrospective study is to
clinically evaluate PTFJ in patients with total knee arthroplasty
(TKA) performed for end-stage primary osteoarthritis
with genu varum deformity.

MATERIALS AND METHODS: Patients with TKA performed
for severe osteoarthritis with genu varum deformity
were retrospectively evaluated. Relationships between
PTFJ clinical examination findings and PTFJ type, hamstring
tightness, and lateral joint line (LJL) tenderness were
investigated using the chi-square test. Also, descriptive
statistics were used.

RESULTS: Fifty-four patients (five male and 49 female;
mean age 62.7 years; range 46-81 years) constituted the
study group. Both knees were operated in 30 (55.6%) patients.
Average follow-up period was 21.6 months (range
12-49 months). PTFJ tenderness, hamstring tightness,
and LJL tenderness were established in six (7.1%), four
(4.8%), and six (7.1%) knees, respectively. There were six
(7.1%) knees with horizontal type PTFJ and 78 (92.9%)
knees with oblique type PTFJ. PTFJ tenderness was determined
in knees with oblique type PTFJ (chi-square test,
p=0.000), knees with LJL tenderness (chi-square test,
p=0.000), and knees with hamstring tightness (chi-square
test, p=0.000).

CONCLUSIONS: PTFJ does not seem to be the exact source
of lateral knee pain after TKA operations in knees with
severe degenerative joint disease and varus malalignment.
However, it should be considered that oblique-type
PTFJ may have the potential to create pain in these
knees

Anahtar Kelimeler

Proximal tibiofibular joint, Total knee arthroplasty, Lateral knee pain

VARUS DİZİLİM BOZUKLUĞU VE PRİMER OSTEOARTROZLU DİZLERDE TOTAL DİZ PROTEZİ SONRASI PROKSİMAL TİBİOFİBULAR KAYNAKLI AĞRI HASTA MUTSUZLUĞUNA NEDEN Mİ?

Öz

AMAÇ: İleri evre gonartrozlarda proksimal tibiafibular eklem
(PTFE) ile tibiofemoral eklem (TFE) arasındaki klinik
ilişki daha önce gösterilmemiştir. Bu retrospektif çalışmanın
amacı son evre gonartrozu olup diz protezi uygulanan
genu varum deformiteli hastalarda PTFE’in klinik değerlendirmesidir.

GEREÇ VE YÖNTEM: İleri evre osteoartrozu olup diz
protezi uygulanan genu varum deformiteli hastalar
değerlendirmeye alındı. PTFE’in klinik muayene bulguları
ile PTFE tipi, hamstring gerginliği, ve lateral eklem aralığı
(LEA) hassasiyeti arasındaki ilişki ki-kare testi kullanılarak
araştırıldı. Ayrıca tanımlayıcı istatistikte kullanıldı.

BULGULAR: Çalışma grubu (5 erkek ve 49 kadın; ortalama
yaş 62.7 yıl; 46-81 arasında) elli dört hastadan oluş-
maktadır. 30 hastanın (%55.6) her iki dizi ameliyat edildi.
Ortalama takip süresi 21.6 ay (12-49 ay). PTFE hassasiyeti,
hamstring gerginliği ve LEA hassasiyeti sırasıyla altı
(%7.1), dört (%4.8), ve altı (%7.1) dizde tespit edildi. Altı
dizde (%7.1) horizontal tip PTFE varken, yetmiş sekiz dizde
(%92.9) oblik tip PTFE vardı. Oblik tip PTFE olan dizlerde
PTFE hassasiyeti (ki-kare testi, p=0.000) , LEA hassasiyeti
(ki-kare testi, p=0.000), hamstring gerginliği (ki-kare
testi, p=0.000) tespit edildi.

SONUÇ: Varus dizilim kusuru olan ileri evre dejeneratif
eklem hastalığı nedeniyle diz protezi yapılan hastalarda,
PTFE’in ameliyat sonrası lateral diz ağrısının kaynağı olmadığı
ortaya konmuştur. Bununla birlikte oblik tip PTFE
bu dizlerde potansiyel ağrı kaynağı olabileceği düşünülebilir

Anahtar Kelimeler

Proksimal tibiofibular eklem, Total diz protezi, Lateral diz ağrısı

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