At least four-year follow-up results of total hip replacement surgery using a direct anterior approach

Yıl 2023, Cilt: 13 Sayı: 1, 19 - 26, 16.03.2023

Abdülhalim Akar , Ahmet Can Erdem , Necmettin Turgut , Amet Çağrı Uyar , Levent Bayam , Mehmet Erdem

https://doi.org/10.31832/smj.1127792

Öz

Objective: This study aims to evaluate the clinical and radiological results of patients who were followed for at least 4 years after treatment with total hip arthroplasty, which was performed using a direct anterior approach and to compare the results with different surgical approaches in the literature.
Materials and Methods: The study included 37 patients who underwent total hip replacement using the direct anterior approach. Harris hip scores and lower extremity functional scores were recorded. The correlations between the scores and gender, diagnosis, body mass index, time of walking time, length of hospital stay, and inclination angle were examined.
Results: Of the cases,26(70.3%) were female and 11(29.7%) were male. The mean age was 51.2 (26-76) years. The patients were followed up for an average of 58 (48-72) months. No significant difference was determined between the improvement in Harris hip score and gender, age, body mass index, and length of hospital stay. Postoperative acetabular inclination was 40.8° (35 - 55). The early dislocation was observed in one of our patients. Serous discharge developed in three patients. In three patients, n.cutaneus femoralis lateralis injury developed. The periprosthetic fracture was observed during surgery in five patients.
Conclusion: In our study, it was seen that patients have successful and fast functional results when total hip replacement using a direct anterior approach was performed. Compared to the literature, faster recovery is observed in the early period compared to other approaches; however, no difference is seen between the approaches in the mid- and long term.
Keywords: Direct anterior approach, Total hip arthroplasty, mid-term results

Anahtar Kelimeler

direct anterior approach, total hip arthroplasty, mid-term results

Direk anteriror yaklaşım kullanılarak uygulanan total kalça protez cerrahisinin en az dört yıllık takip sonuçları

Öz

Amaç: Bu çalışmanın amacı, direk anterior yaklaşım kullanılarak uygulanan ve en az 4 yıl takip edilen total kalça artroplastisi ile tedavi edilmiş hastaların klinik ve radyolojik sonuçlarının değerlendirilmesi, elde edilen sonuçların literatürdeki farklı cerrahi yaklaşımlar ile karşılaştırılmasıdır.
Gereç ve Yöntem: Direk anterior yaklaşım kullanılarak total kalça protezi uygulanan 37 hasta çalışmaya alındı. Harris kalça skorları ve alt ekstremite fonksiyonel skorları kaydedildi. Elde edilen skorlar ile cinsiyet, tanı, vücut kitle indeksi, yürüme zamanı, yatış süreleri ve inklinasyon açısı arasındaki ilişki araştırıldı.
Bulgular: Olguların 26’sı kadın (%70,3), 11’i erkek (%29,7) olup ortalama yaş 51.2(26-76) idi. Hastalar ortalama 58 (48-72) ay takip edildi. Harris kalça skorundaki düzelme ile cinsiyet, yaş, vücut kitle indeksi ve yatış süreleri arasında anlamlı bir fark görülmedi. Ameliyat sonrası grafilerde asetabular inklinasyon ortalama ortalama olarak 40,8°(35 - 55)ölçüldü. Hastalarımızın birinde erken dönem dislokasyon görüldü. Üç hastada seröz akıntı gelişti. .Üç hastada n.cutaneus femoralis lateralis hasarı gelişti. Beş hastada ameliyat sırasında periprostetik kırık görüldü.
Sonuç: Yaptığımız çalışmada, direk anterior yaklaşım kullanarak uygulanan total kalça protezi, uygun endikasyon ve cerrahi teknikle yapıldığında hastalarda başarılı ve hızlı fonksiyonel sonuçlar elde edildiği görülmektedir. Literatür ile karşılaştırıldığında erken dönemde diğer yaklaşımlara göre daha hızlı iyileşme görülmekte fakat orta ve uzun dönemde yaklaşımlar arasında fark görülmemektedir.
Anahtar kelimeler:Direk anterior yaklaşım,kalça artroplasitisi, orta dönem sonuçlar

Anahtar Kelimeler

direk anterior yaklaşım, total kalça artroplasti, klinik ve radyolojik sonuçlar, orta dönem takip

Kaynakça

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