The Impact of Different Anterior Cruciate Ligament Status on Unicompartmental Knee Arthroplasty: Short Term Clinical and Functional Results

Öz

Purpose: Purpose of this study is to compare the short-term results of unicompartmental knee arthroplasty applied stable knees regardless of the condition of the ACL and the application of unicompartmental knee arthroplasty and ACL reconstruction combined surgery applied to ACL deficient cases with anterior instability and to identify the condition and function of the ACL for success in this surgery. Patients and Methods: 80 out of the 105 patients who were operated in 2013-2015 and came for follow-up were included in the study and the patients were divided into four groups. The VAS pain score, KSS Score, WOMAC score, OKS questionnaires and joint range of motion measurements were conducted pre-operatively and post-operatively. One leg standing test, joint position sense measurement, and isokinetic muscle strength test were performed in post-operative controls. Results: There was no statistically significant difference between the demographic data and follow-up of the groups (p˃0.05). While there was a statistically significant difference in knee flexion between Group 2-Group 4 and Group 3-Group 4 in the pre-operative period, no difference was found in the post-operative period (p˃0.05). While there was no difference among the groups, knee joint range of motion in direction of extension declined in a statistically significant way in all four groups (p˂0.05). Pain felt postoperatively was the most in Group 1 and the least in Group 3. A statistically significant difference was found between Group 1 and Group 3 in the test performed with the eyes closed (p˂0.05). Conclusion: The presence of a functional anterior cruciate ligament is expected to make a positive contribution to surgical results especially in young patients with high activity expectation. Whether the patient’s ACL rupture is primary or secondary and his/her activity expectation should be effective in the choice of a surgical method.

Anahtar Kelimeler

• Medial compartment osteoarthritis
• unicompartmental knee arthroplasty
• anterior cruciate ligament
• pain
• joint position sense
• muscle strength

Unikompartmantal Diz Artroplastisine Ön Çapraz Bağ Durumunun Etkisi: Kısa Dönem Klinik ve Fonksiyonel Sonuçlar

Öz

Amaç: Bu çalışmanın amacı ön çapraz bağın durumuna bakılmaksızın stabil dizde uygulanan unikompartmantal diz artroplastisi ile anterior instabilitesi ve ön çapraz bağ eksikliği olan olgularda unikompartmantal diz artroplastisi ve ön çapraz bağ rekonstrüksiyonu uygulanan hastaların kısa dönem sonuçlarını karşılaştırmak ve unikompartmantal diz artroplastisinde cerrahinin başarını arttırmak için ön çapraz bağın durumunu ve işlevini belirlemektir. Hastalar ve Yöntem: 2013-2015 yıllarında opere edilen ve kontrole gelen 80 hasta çalışmaya dahil edildi ve hastalar dört gruba ayrıldı. Pre-operatif ve post-operatif VAS ağrı skoru, KSS Skoru, WOMAC skoru, OKS skoru ve eklem hareket açıklığı değerlendirmeleri yapıldı. Post-operatif kontrollerde tek ayak denge testi, eklem pozisyon hissi ölçümü ve izokinetik kas kuvvet testi uygulandı. Bulgular: Grupların demografik verileri arasında istatistiksel olarak anlamlı fark yoktu (p˃0,05). Grup 2-Grup 4 ve Grup 3-Grup 4 arasında pre-operatif dönemde diz fleksiyonunda istatistiksel olarak anlamlı fark bulunurken, post-operatif dönemde fark saptanmadı (p˃0,05). Diz ekstansiyonu dört grupta da istatistiksel olarak anlamlı düzeyde azaldı (p˂0,05). Post-operatif ağrı en fazla Grup 1'de, en az ise Grup 3'te görüldü. Gözler kapalı yapılan denge testinde Grup 1 ile Grup 3 arasında istatistiksel olarak anlamlı fark bulundu (p˂0,05). Sonuç: Özellikle aktivite beklentisi yüksek olan genç hastalarda fonksiyonel ön çapraz bağ varlığının cerrahi sonuçlara olumlu katkı sağlaması beklenmektedir. Hastanın ÖÇB yırtığının primer veya sekonder olması ile aktivite beklentisi cerrahi yöntemin seçiminde etkili olmalıdır.

Anahtar Kelimeler

• medial kompartman osteoartriti
• unikompartmantal diz artroplastisi
• ön çapraz bağ
• ağrı
• eklem pozisyon hissi
• kas kuvveti

Kaynakça

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