Crowe tip ıv koksartrozlu olgularda kısaltma osteotomili kalça protezi kısa dönem sonuçları
Küçük Resim Yok
Tarih
2015
Yazarlar
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Dergi ISSN
Cilt Başlığı
Yayıncı
Maltepe Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada Crowe tip IV gelişimsel kalça displazisine sekonder osteoartrit gelişen hastaların, kısaltma osteotomili çimentosuz total kalça protezi ile tedavisinin kısa dönem sonuçları değerlendirilmiştir. Çalışmamıza 2010-2014 yılları arasında Maltepe Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı'nda aynı cerrah tarafından total kalça artroplastisi uygulanan, gelişimsel kalça displazisi zemininde koksartrozu mevcut bulunan, Crowe tip 1,2,3,4 gruplarındaki toplam 58 kalçanın, Crowe tip 4 grubundaki 14(%24) kalça dahil edildi. Sonuç olarak 9 hastanın 14 kalçası değerlendirildi.Çalışmada yer alan 9 hastanın 9'uda kadın olup, olguların yaşları 42 ile 52 arasında ve ortalama 46,57±3,15 idi. Ameliyat olan hastaların her bir kalça için takip süresi 12 ay ile sınırlandırılmıştır. Beş hasta bilateral olarak ameliyat edildi. Üç kalçaya önceden periasetabular ve femoral osteotomi uygulanmıştı. Hastaların preoperatif ve postoperatif 6. ay ve 1. yıl kontrollerindeki Harris kalça puanları, Oswestry skalası, VAS kalça ve bel ağrı skalası ve SF36 yaşam kalite indeksleri hesaplandı. Ameliyat öncesi41,86±8,63 olan Harris kalça skorunun, yapılan 6. ay kontrolünde ortalama 85.46±2.51'e, yapılan 1. yıl kontrolünde ortalama 89,97±1,52'e yükseldiği görüldü (p=0.001; p<0.01). Ameliyat öncesi VAS Kalça ölçümleri ortalama 8,50±0,76 iken, ameliyat sonrası 6. ay VAS Kalça ölçümleri ortalama 2,64±0,50 ve ameliyat sonrası 1.yıl kalça VAS ölçümleri ortalama 2,14±0,36'dır (p=0.001;p<0.01). Hastaların ameliyat öncesine göre ameliyat sonrası SF-36 yaşam kalite indeks artışı istatistiksel olarak anlamlı bulundu (p<0.001). Hastaların ameliyat öncesi Oswerstry düzeyleri incelendiğinde; %14,3'ünün (n=2) %40-%60 düzeyinde olduğu yani ağrının günlük yaşamını ileri derece kısıtladığı; %85,7'sinin (n=12) %60-%80 düzeyinde olduğu yani ağrının günlük yaşamını tamamen kısıtladığı görülmektedir. Hastaların ameliyat sonrası ve 1.yıl kontrol Oswerstry düzeyleri incelendiğinde; tamamının (n=14) %0-%20 düzeyinde olduğu yani ağrının hastanın yaşamında önemli bir problem oluşturmadığı görülmektedir.Fonksiyonel ve klinik sonuçlara bakıldığında hastaların %85,7'sinde iyi veya mükemmel sonuc elde edildi. Crowe tip IV GKD vakalarında konservatif tedaviye yanıt vermeyen sekonder osteoartritin sebep olduğu ağrı ve fonksiyon kaybının cerrahi tedavisinde kısaltma osteotomili çimentosuz total kalça artroplastisi uygulamalarının yaşam kalitesi, ağrı ve fonksiyon parametreleri açısından sonuçları oldukça iyidir.
In this retrospective study,we evaluated the short term results of cementless total hip replacement with shortening osteotomy at Crowe typeIVhips who developed secondary osteoartritisdue to developmental dysplasia of the hip. Our study included14 (24%) Crowe type IV dysplastic hips from group of Crowe type 1,2,3,4 dysplastic patients with coxarthrosis which applied total hip arthroplasty by the same surgeon at Maltepe University Medical Faculty Orthopaedics and Traumatology Departmentbetween2010-2014years. As a result, 14 hips of 9 patients were evaluated. All 9 patients in the study were women between age 42 to 52 and the average age of the patients was 46.57 ± 3.15.Follow-up for each of the patients with hip surgery is limited to 12 months. Five patients were operated bilaterally. Threehips had been treated with periacetabular and femoral osteotomypreviously.Harris hip scores, Oswestry scores, hip and back pain VAS scale and SF36 quality of life indices of all patients was calculated and evaluated preoperatively andat 6 months and 1st year postoperatively. After operation, Harris hip score rised from 41.86 ± 8.63 to 85.46±2.51at 6month and to 89.97 ± 1.52 at 1styear control (p = 0.001; p <0.01).While the VAS hip measurements 8.50 ± 0.76 before surgery,it has been changed to 2.64 ± 0.50 after 6 month and to 2.14 ±0.36 at1 year (p = 0.001; p <0.01).The increase at the SF-36 life quality index was statistically significant as well (p <0.001).While we examine the Oswestry level before the surgery, we can see that 14.3% (n = 2) was at level of 40% - 60% which means the pain severely restrict the daily life and85.7% (n = 12) was at level of 60%- 80% which means the pain totally restricted the daily life.The Oswestry results of all patients (n= 14)at 1st year controls after the surgery were at 0% - 20% levelswhich means the pain was not a major problem at the patients life. With considering the functional and clinical outcomes 85.7% of the patients had good or excellent results. For surgical treatment of pain and loss of function complaints occured as a result of secondary osteoarthritis which is unresponsive to conservative treatment in the cases of Crowe type IV developmental dysplasia of the hip, implemantation of cementless total hip arthroplasty with shortening osteotomyhasgood results on quality of life, pain and function parameters.
In this retrospective study,we evaluated the short term results of cementless total hip replacement with shortening osteotomy at Crowe typeIVhips who developed secondary osteoartritisdue to developmental dysplasia of the hip. Our study included14 (24%) Crowe type IV dysplastic hips from group of Crowe type 1,2,3,4 dysplastic patients with coxarthrosis which applied total hip arthroplasty by the same surgeon at Maltepe University Medical Faculty Orthopaedics and Traumatology Departmentbetween2010-2014years. As a result, 14 hips of 9 patients were evaluated. All 9 patients in the study were women between age 42 to 52 and the average age of the patients was 46.57 ± 3.15.Follow-up for each of the patients with hip surgery is limited to 12 months. Five patients were operated bilaterally. Threehips had been treated with periacetabular and femoral osteotomypreviously.Harris hip scores, Oswestry scores, hip and back pain VAS scale and SF36 quality of life indices of all patients was calculated and evaluated preoperatively andat 6 months and 1st year postoperatively. After operation, Harris hip score rised from 41.86 ± 8.63 to 85.46±2.51at 6month and to 89.97 ± 1.52 at 1styear control (p = 0.001; p <0.01).While the VAS hip measurements 8.50 ± 0.76 before surgery,it has been changed to 2.64 ± 0.50 after 6 month and to 2.14 ±0.36 at1 year (p = 0.001; p <0.01).The increase at the SF-36 life quality index was statistically significant as well (p <0.001).While we examine the Oswestry level before the surgery, we can see that 14.3% (n = 2) was at level of 40% - 60% which means the pain severely restrict the daily life and85.7% (n = 12) was at level of 60%- 80% which means the pain totally restricted the daily life.The Oswestry results of all patients (n= 14)at 1st year controls after the surgery were at 0% - 20% levelswhich means the pain was not a major problem at the patients life. With considering the functional and clinical outcomes 85.7% of the patients had good or excellent results. For surgical treatment of pain and loss of function complaints occured as a result of secondary osteoarthritis which is unresponsive to conservative treatment in the cases of Crowe type IV developmental dysplasia of the hip, implemantation of cementless total hip arthroplasty with shortening osteotomyhasgood results on quality of life, pain and function parameters.
Açıklama
Anahtar Kelimeler
Gelişimsel kalça displazisi, Osteoartrit, Artroplasti, Femoral kısaltma osteotomisi, Developmental dysplasia of the hip, Osteoarthritis, Arthroplasty, Femoral shortening osteotomy
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Polat, Ö. (2015). Crowe tip ıv koksartrozlu olgularda kısaltma osteotomili kalça protezi kısa dönem sonuçları / Short-term results of shortening osteotomy and total hip replacement crowe TYPE IV dysplastic coxarthrosi·s cases. (Yayımlanmamış Tıpta Uzmanlık Tezi). Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.