Bora BOSTAN, Cengiz ŞEN, TANER GÜNEŞ, MEHMET ERDEM, Kürşat AYTEKİN, ÜNAL ERKORKMAZ

Minimal invaziv anterolateral teknikle total kalça protezi

Amaç: Minimal invaziv anterolateral (MİA) ve standart anterolateral (SA) yaklaşımlarla yapılan total kalça protezi (TKP) ameliyatlarının klinik ve radyograﬁk sonuçları değerlendirildi. Çalışma planı: Çalışmada, TKP ameliyatı SA yaklaşımla yapılan 25 hasta (17 kadın, 8 erkek; ort. yaş 57.7±12.5) ve MİA yaklaşımla yapılan 15 hasta (11 kadın, 4 erkek; ort. yaş 68.9±5.5) geriye dönük olarak incelendi. İki grupta ortalama vücut kütle indeksi sırasıyla 32.5±5.8 kg/m2 ve 28.7±2.7 kg/m2idi. Hastalar kan kaybı, ameliyat süresi, kan transfüzyon miktarı ve hastanede yatış süresi açısından karşılaştırıldı. Ağrı görsel analog skala (GAS), fonksiyonel sonuçlar Harris kalça skoru (HKS) ile değerlendirildi. Ayrıca, tüm hastalara ameliyat öncesi ve sonrasında SF-36 uygulandı. Radyograﬁk olarak, son kontrollerde femoral ve asetabular bileşenler ve gevşeme bulguları değerlendirildi. Ortalama takip süresi SA grubunda 25.2±8.7 ay, MİA grubunda 26.1±7.2 ay idi. Sonuçlar: Kanama ve kan transfüzyon miktarları ve hastanede yatış süresi MİA grubunda anlamlı derecede daha az idi (p0.05). İki grup arasında ameliyat öncesi GAS ve HKS skorları açısından anlamlı fark yoktu. Ağrı ve HKS skorlarındaki iyileşme MİA grubunda daha belirgin idi (p

Anahtar Kelimeler:

Cerrahi işlemler, minimal invaziv, Artroplasti, replasman, kalça, Artroplasti, replasman, Geriyedönük çalışma, Kalça protezi

Total hip arthroplasty using the anterolateral minimally invasive approach

Objectives: We evaluated the clinical and radiographic results of total hip arthroplasties (THA) performed with the minimally invasive anterolateral (MIA) and standard anterolateral (SA) approaches. Methods: We retrospectively reviewed 25 patients (17 women, 8 men; mean age 57.7±12.5 years) and 15 patients (11 women, 4 men; mean age 68.9±5.5 years) who underwent THA with the SA and MIA approaches, respectively. The mean body mass index was 32.5±5.8 kg/m2 in the SA group and 28.7±2.7 kg/m2 in the MIA group. The two groups were compared with respect to blood loss, operation time, blood transfusions, and length of hospital stay. Pain was assessed with a visual analog scale (VAS), and functional results were assessed with the Harris hip score (HHS). The SF-36 questionnaire was administered pre- and postoperatively. Radiographic evaluations included femoral and acetabular components and signs of loosening. The mean follow-up was 25.2±8.7 months in the SA group and 26.1±7.2 months in the MIA group. Results: The amount of blood loss and blood transfusions were signiﬁcantly reduced and length of hospital stay was signiﬁcantly shorter in the MIA group (p<0.001). The mean operation time did not differ between the two groups (p>0.05). Improvements in the VAS and HHS scores were signiﬁcantly better in the MIA group (p<0.001). Similarly, improvements in all the SF-36 subscales other than general health, mental health, and role-physical subscales were significantly greater in the MIA group. Radiographically, no signs of loosening and osteolysis were seen. Superﬁcial or deep wound infections did not occur. Conclusion: Compared to the SA approach, the MIA approach in THA operations is associated with shorter hospital stay, reduced blood loss and blood transfusions, better postoperative pain control, and higher levels of improvements in HHS and SF-36 scores.

Keywords:

Surgical Procedures, Minimally Invasive, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Retrospective Studies, Hip Prosthesis,

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