Erken evre Gonartrozda yüksel tibial osteotomi başarılı mı
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Dosyalar
Tarih
2022
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
2017-2020 yılları arasında Trakya Üniversitesi Ortopedi ve Travmatoloji Anabilim Dalında tedavi gören hastaların dosyaları etik kurul onayı (Ek-1) alındıktan sonra geriye dönük olarak tarandı. Bu çalışmada preop Kellgren Lawrence evresi 1-2 olan hastalarda medial açık kama osteomisinin orta dönemde başarılı olup olmadığını değerlendirmeyi amaçladık. Bu çalışma Trakya Üniversitesi Ortopedi ve Travmatoloji Kliniğinde ameliyat edilen 28 hastanın preop ve postop verileri üzerinden yapıldı. Takip süresi tam 2 yıl olan hastalar çalışmaya katıldı. Çalışmamızda preop ortalama 57,29 olan Womac skorunun postop 2.yıl değerlendirmede 18,86’ya düşerek anlamlı bir iyileşme göstermiştir. Lysholm skorununda preop dönemde ortalama 42,79’dan postop 83’e yükselerek anlamlı bir artış sağlamıştır. Ağrının değerlendirilmesi için kullandığımız VAS skorununda anlamlı azalma görüldü. Hastalarımızın yaş ortalamasının (ortalama yaş 52) endikasyonlar sınırları dahilinde olmasından dolayı fonksiyonel ve ağrı skorlarmaları ile aralarında anlamlı bir ilişki ortaya çıkmadı ancak VKİ ortalamamız 31,95 kg/m 2 olarak obezite sınırları içersindeydi. Hastalarımızın %96,4’ünün VKİ’i 25 kg/m 2 üzerindeydi. Obez hastalarda da fonksiyonel iyileşme açısından medial açık kama osteotomisinin başarılı olduğunu bulundu. Postop dönemde Caton-Deschamps indeksinin anlamlı olarak azaldığını postop dönemde ise sadece 4 hastada patellofemoral ağrı olduğunu, bununda hastalar üzerinde bir memnuniyetsizlik yaratmadığı bulundu. MAKO’si yapılan hastarımızda orta dönemde Kellgren-Lawrence evresinde artış olmadığını aynı seviyede kaldığını gösterilmiş olundu. Sonuç olarak bu bulgular; 60 yaşından küçük, normal kilolu ya da obez, KellgrenLawrence evre 1 ve 2 gonartrozu olan ve preop çekilen mr görüntüsünde lateral kompartmanda kıkırdak ve menisküs hasarı olmayan hastalarda medial açık kama osteotominin başarılı olduğunu gösterdi.
The files of the patients who were treated in the Department of Orthopedics and Traumatology of Trakya University between 2017-2020 were reviewed retrospectively after obtaining ethics committee approval (Annex-1). In this study, we aimed to evaluate whether medial open wedge osteomies were successful in the mid-term in patients with preoperative Kellgren Lawrence stage 1-2. This study was carried out on the preoperative and postoperative data of 28 patients who were operated on in Trakya University Orthopedics and Traumatology Clinic. Patients with a follow-up period of 2 years participated in the study. In our study, the Womac score, which was 57.29 preoperatively, decreased to 18.86 in the postoperative 2nd year, showing a significant improvement. It provided a significant increase in the Lysholm score from 42.79 in the preoperative period to 83 in the postoperative period. A significant decrease was observed in the VAS score, which we used for the assessment of pain. Since the mean age of our patients (mean age 52 years) was within the limits of indications, there was no significant relationship between functional and pain scores, but our mean BMI was within the obesity limit of 31.95 kg/m2. The BMI of 96.4% of our patients was over 25 kg/m2. It was found that medial open wedge osteotomy was also successful in terms of functional recovery in obese patients. It was found that the Caton-Deschamps index decreased significantly in the postoperative period and that only 4 patients had patellofemoral pain in the postoperative period, which did not cause any dissatisfaction in the patients. It has been shown that there was no increase in the Kellgren-Lawrence stage in the midterm in our patient who underwent medial open wedge osteotomy and remained at the same level. As a result, these findings; showed that medial open wedge osteotomy was successful in patients younger than 60 years of age, normal weight or obese, with Kellgren-Lawrence grades 1 and 2 gonarthrosis, and without cartilage and meniscus damage in the lateral compartment in the preoperative MRI.
The files of the patients who were treated in the Department of Orthopedics and Traumatology of Trakya University between 2017-2020 were reviewed retrospectively after obtaining ethics committee approval (Annex-1). In this study, we aimed to evaluate whether medial open wedge osteomies were successful in the mid-term in patients with preoperative Kellgren Lawrence stage 1-2. This study was carried out on the preoperative and postoperative data of 28 patients who were operated on in Trakya University Orthopedics and Traumatology Clinic. Patients with a follow-up period of 2 years participated in the study. In our study, the Womac score, which was 57.29 preoperatively, decreased to 18.86 in the postoperative 2nd year, showing a significant improvement. It provided a significant increase in the Lysholm score from 42.79 in the preoperative period to 83 in the postoperative period. A significant decrease was observed in the VAS score, which we used for the assessment of pain. Since the mean age of our patients (mean age 52 years) was within the limits of indications, there was no significant relationship between functional and pain scores, but our mean BMI was within the obesity limit of 31.95 kg/m2. The BMI of 96.4% of our patients was over 25 kg/m2. It was found that medial open wedge osteotomy was also successful in terms of functional recovery in obese patients. It was found that the Caton-Deschamps index decreased significantly in the postoperative period and that only 4 patients had patellofemoral pain in the postoperative period, which did not cause any dissatisfaction in the patients. It has been shown that there was no increase in the Kellgren-Lawrence stage in the midterm in our patient who underwent medial open wedge osteotomy and remained at the same level. As a result, these findings; showed that medial open wedge osteotomy was successful in patients younger than 60 years of age, normal weight or obese, with Kellgren-Lawrence grades 1 and 2 gonarthrosis, and without cartilage and meniscus damage in the lateral compartment in the preoperative MRI.
Açıklama
Anahtar Kelimeler
Gonartroz, Yüksel tibial osteotomi, Medial açık kama osteotomi, Gonarthrosis, High tibial osteotomy, Medial open wedge osteotomy
