Arif ÖZKAN, Halil ATMACA

Diz Osteoartriti Olan Hastalarda Gebelik Ve Vücut Kitle İndeksinin Etkisi

AMAÇ: Kadınlarda diz osteoartriti gonartroz ile vücut kitle indeksi VKİ , doğum sayısı ve yaş gibi değişkenlerin ilişkisini araştırmakYÖNTEMLER: Kliniğimize başvuran ve gonartroz tanısı alan ortalama yaşları 60,4 40-88 yıl olan 88 hasta değerlendirmeye alınmıştır. Hastaların yaşları, kilo ve boy değerleri, doğum sayıları, kaydedilmiştir. Şikayeti olan diz için AP-Yan grafilerinden radyolojik evreleme, WOMAC OA indeksi The Western Ontario and Mcmaster Universities Osteoarthritis İndeks ve Lequesne Diz Osteoartrit Şiddet İndeksi kullanılarak skorlama yapılmıştır.BULGULAR: Çalışmada değerlendirilen 88 kadın hastanın ortalama VKİ’ leri 28,3 19,8- 42,7 idi. Ortalama doğum sayısı ise 7 0-13 . Kellgren-Lawrance evreleme sistemine göre 2 hasta evre 1, 37 evre 2, 36 evre 3, 13 hasta ise evre 4 idi. Hastaların ortalama toplam WOMAC OA skorları 66,7 22-91 iken WOMAC Ağrı skoru ortalama 13,2 4-20 , Tutukluluk ortalama 4,8 2-8 , fonksiyon ortalama 48,6 16-65 . Lequesne ağrı skoru ortalama 5,2 2-8 , yürüme mesafesi ortalama 4 1-7 , günlük aktivite ortalama 4,6 1-8 iken toplam Lequesne skoru ise ortalama 13,9 5- 23 idi. Hastanın yaşı ile WOMAC toplam, ağrı ve fonksiyon, Lequesne toplam ve yürüme mesafesi skorları arasında istatistiki olarak anlamlı ve pozitif korelasyon bulunurken, WOMAC tutukluluk, Lequesne ağrı, günlük aktivite skorları arasında anlamlı korelasyon bulunmamıştır. VKİ ile WOMAC toplam skor haricindeki tüm parametrelerde istatistiki olarak anlamlı pozitif ilişki bulunmuştur. Doğum sayıları incelendiğinde Doğum sayısı arttıkça yine WOMAC toplam skor haricindeki tüm parametrelerde istatistiki olarak anlamlı dercede artış olmaktadırSONUÇ: VKİ, yaş ve doğum oranı arttıkça diz ekleminde dejenerasyon artmakta ve yaşam kalitesi azalmaktadır.

Anahtar Kelimeler:

Doğum, Gonartroz, Vücut kitle indeksi

The Effect of Pregnancy and Body Mass Index in Patients With Knee Osteoarthritis

OBJECTIVE: To evaluate the association between knee osteoarthritis and either body mass index BMI or pregnancy in women.METHODS: 88 patients with average age of 60,4 40-88 years were evaluated. Age, weight, height, and number of pregnancy of the patients were recorded. Radiographic staging was detected from Anterior Posterior- Lateral radiographs of the knee. WOMAC OA index The Western Ontario and Mcmaster Universities Osteoarthritis Index and Lequesne Knee Osteoarthritis severity scores were used to investigate clinical scoring.RESULTS: The mean BMI was 28,3 19,8- 42,7 . The mean pregnancy was 7 0-13 . According to Kellgren-Lawrance staging system; 2 Patients were stage 1, 37 were stage 2, 36 were stage 3 and 13 were stage 4. The mean total WOMAC OA score of the patients was 66,7 22-91 , while the mean pain score was 13,2 4-20 , Stiffness was 4,8 2-8 , function was 48,6 16-65 . The mean Lequesne score was 13,9 5- 23 , pain was 5,2 2-8 , mean walking distance was 4 1-7 and the mean daily activity score was 4,6 1-8 . There was statistically significant positive correlation between age and WOMAC total, pain, function, Lequesne total, walking distance scores while there was no statistically significant between WOMAC stiffness, Lequesne pain, daily activity scores. With respect to BMI and pregnancy all parameters except WOMAC total score were statistically significant positive correlated with either BMI or pregnancy.CONCLUSION: Degeneration in the knee joint increases and quality of life decreases with increasing of age, BMI, pregnancy.

Keywords:

Pregnancy, Gonartroz, Body mass index,

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