Minimal İnvaziv Unikompartmantal Diz Artroplasti (MİUCA) Oxford Grubu Radyolojik Değerlendirmesine göre Sık Uygulama Hataları

Amaï¿½: Nisan 2010 ve Eylül 2019 tarihleri arasında aynı cerrah tarafından,aynı yöntem ile Minimal İnvaziv Unikompartmantal Diz Artroplastisi(MİUCA) uygulanmış 93 hastanın 104 dizi çalışmaya alındı. Bu çalışmada amacımız: MİUCA’da uygulamaya bağlı teknik hataların, Oxford gurubunun radyolojik değerlendirme kriterleri kullanılarak, sık yapılan implant uygulama kusurlarının ortaya konmasıdır. Hastalar ve Yï¿½ntem: Bu çalışmaya Nisan 2010 ve Temmuz 2017 arasında MİUCA uyguladığımız ve takiplerini kayıt altına alabildiğimiz 94 hastanın 104 dizi çalışmaya alındı, 13 erkeğin 14 dizi ve 80 kadının 90 dizi. Ortalama kadın yaşı; 56.38 (dağılım: 46-74) ve ortalama erkek yaşı; 57.80 (dağılım: 48-66). Ortalama yaş; 57.12 (dağılım:46-74). Ortalama takip süresi:58 ay (dağılım:3-104). 82 dize fix-bearing, 22 dize mobil-bearing MİUCA uygulandı. Preoperatif dönemde: standart iki yönlü diz grafisi ile medial eklemdeki OA derecesi ve valgus stres testi ile varus deformitesinin esnekliği değerlendirildi. Postoperatif değerlendirmede; hastalara rutin iki yönlü diz grafisi çekilerek, Oxford diz grubunun önerdiği radyolojik ölçümler yapıldı(8). MİUCA uygulanan dizler bir bütün olarak Oxford grubunun önerdiği 17 kriterin tamamı ile değerlendirildi. Bulgular: Tibial komponent; Varus-Valgus:-4 (valgus) ve 8 (varus) derece aralığı dışında iki hasta bulundu. Tibial posterior eğim: İki dizde (8 ve 10 derece) yüksek ölçüldü. İmplantta taşma durumu: 11 diz posterior, 2 diz anterior ve 2 dizde medial platodan 2 mm ve üstü taşma görüldü. Tibial sement taşma durumu: 12 dizde vardı.rn Femoral komponenet;varus-valgus: 34 diz valgusta, ortalama: 5.41 (dağılım:3-10 derece), 19 diz varusta, ortalama: 4.58 (dağılım:4-8 derece) kabul edilebilir sınırlardaydı. Fleksiyon-Estensiyon durumu; 52 diz fleksiyonda,ortalama: 3.95 (dağılım:2-35 derece) ölçüldü, bunlardan 21 diz 5 dereceden fazla fleksiyonda ölçüldü. 16 diz ekstensiyonda ortalama: 3 (dağılım:1-10 derece) ölçüldü, bunlardan 4 diz 5 dereceden fazla ekstensiyonda ölçüldü. rn Sonuï¿½:Oxford diz gurubunun postoperatif MİUCA değerlendirmedsine göre sık uygulama hatalarımız; Femoral komponentte protezin 5 derece üstünde fleksiyonda uygulanması(21 diz), femoral komponentin arka duvarında 2 mm gap varlığı(20 diz). Tibial komponentte protezin posteriore taşması(11 diz), tibial komponentteki sementin taşması(12 diz).

Radiological evaluation results of minimally invasive unicompartmental knee arthroplasty (MİUCA) in Oxford group

Purpose:our aim is to reveal the technical errors and rnangular deformities related to the application in MİUCA, using the radiological evaluation criteria rnof the Oxford group, the most common implant application defects.rn Patients and Methods: 14 knee of 13 men and 90 knee of 80 women were included in the study. Average female age; 56.38 ( range: 46-74 ) and average male age; 57.80 ( range: 48-66 ). Average age; 57.12 ( range: 46-74 ) Average follow-up time: 58 months ( range: 3-104 ), 82 fix-beaing, 22 mobile-bearing MIUCA were applied. In the preoperative period: we evaluated the degree of OA in the medial joint with standard bilateral knee radiography and the flexibility of varus deformity with valgus stress test. In the postoperative evaluation; Radiological measurements recommended by the Oxford knee group were performed by routine two-way knee radiography. The knees applied to MIUCA were evaluated with 17 criteria suggested by the Oxford group as a whole. Results:Tibial component: Varus / Valgus: Two patients were found outside the range of -4 (valgus) and 8 (varus) degrees. Slope: In two knees ( 8 and 10 degrees ), slope was measured outside the normal limit. Overflow in the implant: 11 knee posterior, 2 knee anterior and 2 knee overflow from the medial plateau were seen. Femoral component: Valgus-Varus position: Average of 34 knee valgus: 5.41 ( range: 3-10 degrees ), 19 knee varus. Average: 4.58 ( range: 4-8 degrees ). Flexion-Esthesion status: 52 knee flexion, mean: 3.95 ( range: 2-35 degrees ) measured. 21 knees were measured over 5 degrees of flexion. Conclusion:In our patients, where we applied MUCA; Increased error in femoral component: application of the prosthesis in flexion ( above 21 knee-5 degrees ), the most common error in the tibial component: prosthesis overflow ( 11 knees ).

Keywords:

Gonartroz, Unicompartmental knee arthroplasty,

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