Koksartrozda cerrahi tedoavi endikasyonunun belirlenmesinde uzmanlık alanları arasındaki farklılıklar
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Dosyalar
Tarih
2014
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Total kalça protezi ameliyatı dünyada en başarılı ve hasta memnuniyeti açısından en iyi olan girişimlerden biridir. Ameliyatın başarısında iyi bir cerrahi teknik, kullanılan implant ve hastaya ait faktörler ile birlikte doğru hasta seçimi de çok önemlidir. Ağrı, fonksiyon kısıtlılığı ve radyografik olarak artroz bulgularının olması total kalça protezi için birincil endikasyonları oluşturmakla beraber bu bulguların hangi seviyeye geldiğinde operasyon yapılması gerektiği konusu hem cerrahlar arasında hem de cerrahlara hasta sevk eden diğer klinisyenler arasında netlik kazanmamıştır. Bu çalışmada Trakya bölgesinde Üniversite ve Devlet Hastanelerinde uzman olarak çalışan Fizik Tedavi ve Rehabilitasyon hekimleri ile Ortopedi ve Travmatoloji hekimlerinin koksartroz hastalarında cerrahi endikasyon ile ilgili yaklaşımları araGtırıldı. 211 Ortopedi ve Travmatoloji uzmanı ile 102 Fizik Tedavi ve Rehabilitasyon uzmanından sıklık % 40 olacak şekilde, % 95 güven aralığı, % 5 yanılma payı ve power % 80 kabul edilerek hesaplanan örneklem miktarına göre 174 Ortopedi ve Travmatoloji uzmanı ve 90 Fizik Tedavi ve Rehabilitasyon uzmanı çalışmaya alındı. Çalışmamıza göre Ortopedi ve Travmatoloji uzmanlarının hastanın yaş ve fonksiyonel durumunu daha az dikkate alarak daha çok cerrahi endikasyon koyduğunu görüldü (p<0,05). Fizik Tedavi ve Rehabilitasyon uzmanlarının ise hastayı öncelikle medikal tedavi ve rehabilitasyon ile tedavi etmeye çalışarak cerrahinin mümkün olduğunca ertelenmesine çalıştıkları gözlemlendi (p<0,001). Ayrıca hastanın beklentilerini ve sosyokültürel düzeyini Ortopedi ve Travmatoloji uzmanlarının daha fazla dikkate aldığıgörüldü (p<0,001). Çalışmamızın sonucunda elde ettiğimiz veriler sadece Fizik Tedavi ve Rehabilitasyon uzmanları ile Ortopedi ve Travmatoloji uzmanları arasında değil, Ortopedi ve Travmatoloji uzmanlarının kendi arasında da tedavi yaklaşımları açısından fark olduğunu ortaya koydu (p<0,001). Bu veriler ışığında çalışmalar sürdürülerek bir tedavi algoritması oluşturulması ve tedavi yaklaşımlarının her hasta için kişiye özel olmakla beraber standardize edilmesi sağlanabilecektir. Böylelikle koksartroz hastalarına daha doğru zamanda, daha doğru tedaviler uygulanarak ülke ekonomisi ve hastanın günlük yaşantısındaki problemlerin çözümü açısından da daha verimli sonuçlar alınacaktır.
Abstract
The surgery of total hip arthroplasty is one of the most succesful and cost-effective procedure with the best patient satisfaction in the world. With a good surgical technic, implant used, considerations belonging to patients as well as a correct patient choice are very important in the success of the surgery. Although for hip arthroplasty, having arthrosis symptoms as pain, function disability and radiographic constitutes primary indications, the subject of in which stage these symptoms catch up requires to carry out an operation hasn?t been turned out to be clear either for surgeons or clinicians who refer patients to surgeons. In this study, Physiotherapy and Rehabilitation Physicians? and Orthopedics and Traumatology Specialists?, -who work as specialists in universities and public hospitals of Trakya region- approaches about surgical indication on coxarthrosis patients has been examined. According to the sample amount calculated from 211 Orthopaedic surgeons and 102 Physiotherapy and Rehabilitation acknowledged with the frequency of 40%, with the confidence interval of 95%, with the fallibility of 5% and with the power of 80%, 174 Orthopaedic surgeons and 90 Physiotherapy and Rehabilitation Physicians have been taken to work.According to our study, it has been seen that the Orthopedics and Traumatology Specialists have been considered patient?s age and functional situation less and put more surgical indication (p<0,05). On the other hand, it is observed that, Physiotherapy and Rehabilitation specialists has been tried to postpone the surgery by treating the patient primarily with medical treatment and rehabilitation (p<0,001). In addition, it was seen that Orthopaedics and Traumatology specialists have been considered more about patients? expectations and sociocultural levels (p<0,001). In consequence of our study, the datas that we achived have been proved that the difference of the treatment approaches is not seen only between Physiotherapy and Rehabilitation specialists and Orthopaedic surgeons but also in Orthopaedic surgeons itself (p<0,001). The studies will be carried on in the light of these datas and by this way, constituting a treatment algorithm and treatment approaches will be personal for every patient as well as it will be able to become standardized. By this way, by performing more correct treatments in the right time to coxarthrosis patients, more productive results will be received in the sense of national economy as well as in terms of solving patient?s daily life problems.
Abstract
The surgery of total hip arthroplasty is one of the most succesful and cost-effective procedure with the best patient satisfaction in the world. With a good surgical technic, implant used, considerations belonging to patients as well as a correct patient choice are very important in the success of the surgery. Although for hip arthroplasty, having arthrosis symptoms as pain, function disability and radiographic constitutes primary indications, the subject of in which stage these symptoms catch up requires to carry out an operation hasn?t been turned out to be clear either for surgeons or clinicians who refer patients to surgeons. In this study, Physiotherapy and Rehabilitation Physicians? and Orthopedics and Traumatology Specialists?, -who work as specialists in universities and public hospitals of Trakya region- approaches about surgical indication on coxarthrosis patients has been examined. According to the sample amount calculated from 211 Orthopaedic surgeons and 102 Physiotherapy and Rehabilitation acknowledged with the frequency of 40%, with the confidence interval of 95%, with the fallibility of 5% and with the power of 80%, 174 Orthopaedic surgeons and 90 Physiotherapy and Rehabilitation Physicians have been taken to work.According to our study, it has been seen that the Orthopedics and Traumatology Specialists have been considered patient?s age and functional situation less and put more surgical indication (p<0,05). On the other hand, it is observed that, Physiotherapy and Rehabilitation specialists has been tried to postpone the surgery by treating the patient primarily with medical treatment and rehabilitation (p<0,001). In addition, it was seen that Orthopaedics and Traumatology specialists have been considered more about patients? expectations and sociocultural levels (p<0,001). In consequence of our study, the datas that we achived have been proved that the difference of the treatment approaches is not seen only between Physiotherapy and Rehabilitation specialists and Orthopaedic surgeons but also in Orthopaedic surgeons itself (p<0,001). The studies will be carried on in the light of these datas and by this way, constituting a treatment algorithm and treatment approaches will be personal for every patient as well as it will be able to become standardized. By this way, by performing more correct treatments in the right time to coxarthrosis patients, more productive results will be received in the sense of national economy as well as in terms of solving patient?s daily life problems.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Artroplasti, Cerrahi Endikasyon, Total Kalça Replasmanı, Total Kalça Artroplastisi, Koksartroz, Total Hip Replacement, Surgical Indications, Arthroplasty, Coxarthrosis, Total Hip Arthroplasty
