İbrahim YANMIŞ, Servet TUNAY, CEMİL YILDIZ, Can SOLAKOĞLU, Ethem GÜR

Çimentosuz total kalça revizyon artroplatisinde klinik deneyimlerimiz

Amaç: Çimentolu total kalça artroplastisi yapılan olgularda uyguladığımız çimentosuz revizyon artroplastisi sonuçlarını değerlendirdik. Çalışma planı: Yirmi olguda (12 kadın, 8 erkek; ort. yaş 72; dağılım 61-84) çimentosuz total kalça revizyonu uygulandı. Primer protez uygulamasından sonra geçen ortalama süre 9.4 yıl (dağılım 3-16 yıl), ortalama izlem süre-si 4.5 yıl (dağılım 3 ay-6.3 yıl) idi. Sonuçlar: Revizyon artroplastisi sırasında üç olguda (%15) femoral kırık, üç olguda (%15) femoral korteks perforasyonu görüldü. Beş olguda (%25) trokanterik osteotomi yapıldı. Ameliyat sonrası Harris kalça skoru ortalaması 76.7 (dağılım 50-90) bulundu. Sonuçlar üç olguda (%15) mükemmel, yedi olguda (%35) iyi, yedi olguda (%35) orta, üç olguda (%15) kötü idi. Çıkarımlar: Çimentosuz total kalça revizyon artroplastileri sırasında, önemli oranda ameliyat içi komplikasyon oluşmaktadır. Buna karşın, enfeksiyon oranlarının düşük olması ve aseptik gevşemenin daha az görülmesi nedeniyle, çimentosuz revizyonların tercih edilmesi gerektiğini düşünüyoruz.

Anahtar Kelimeler:

Asetabulum, Artroplasti, replasman, kalça, Femur kırıkları, Kemik çimentosu, Kalça protezi, Donanım tasarımı, Kalça eklemi

Our clinical experience with non-cemented total hip revision arthroplasty

Objectives: We evaluated the results of non-cemented revision arthroplasty in patients who had undergone cemented total hip arthroplasty. Methods: Twenty patients (12 women, 8 men; mean age 72 years; range 61 to 84 years) underwent non-cemented revision arthroplasty after a mean of 9.4 years (range 3 to 16 years) following primary surgery. The mean follow-up period was 4.5 years (range 3 months to 6.3 years). Results: During revision arthroplasty, femur fractures were observed in three patients (15%). Three patients (15%) had femoral cortex perforations. Trochanteric osteotomy was performed in five patients (25%). The mean Harris hip score after the operation was 76.7 (range 50 to 90). The results were excellent in three patients (15%), good in seven (35%), fair in seven (35%), and poor in three patients (15%). Conclusion: Despite a high intraoperative complication rate during non-cemented revision total hip arthroplasty, we believe that non-cemented revision should be the pre-ferred method because of low infection and low aseptic loosening rates.

Keywords:

Acetabulum, Arthroplasty, Replacement, Hip, Femoral Fractures, Bone Cements, Hip Prosthesis, Equipment Design, Hip Joint,

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