Baybars ATAOĞLU, Ulunay KANATLI, Erdinç ESEN, İhsan ŞENTÜRK

Total diz protezi sonrası yürüme analizi: ameliyat öncesi ve sonrasının değerlendirilmesi

Amaç: Bu çalışmada dejeneratif diz artriti olan hastaların total diz protezi (TDP) ameliyatı öncesi ve ameliyattan sekiz ay sonra ölçülen plantar basınç ölçümlerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Bu amaçla kliniğimizde gonartroz nedeniyle TDP uyguladığımız 13 hastanın 15 dizine, ameliyat öncesi ve sonrası, en az sekiz ay sonra, EMED-SF plantar basınç dağılımı ölçüm sistemi kullanarak dinamik ayak tabanı basınç ölçümleri uyguladık. Tüm hastaların duruş fazı süreleri, toplam basınç değerleri ve COP (yürüme çizgisi) kullanılarak duruş fazında ayak basınçlarının mediale ve laterale yer değiştirmesi hesaplandı. Bulgular: Ameliyat öncesi 1257.75 N/cm2 olan toplam duruş fazı plantar basınç, ameliyat sonrası 1436.0 N/cm2 ‘ye yükseldi. Bu fark istatistiksel olarak düşük derecede anlamı olarak tespit edildi. Ameliyat öncesi 987ms olan toplam duruş fazı süresi ameliyat sonrasında 801.5ms’ye düşmüştür. Mediyolateral alan farkı ameliyat öncesi lateral lehine %0,69 iken ameliyat sonrası ölçümlerde bunun medial lehine %5.17 olarak değiştiği tespit edildi. Sonuç: Dejeneratif artritte ve TDP ameliyatlarında yürüme analizi kullanılarak yapılan cerrahinin etkinliği ölçülebilmekte ve ileri çalışmalarla TDP uygulamalarının, hastaya özel planlanmasında, yararlı olacağına inanmaktayız.

Gait analysis after total knee arthroplasty: comparison of pre and postoperative characteristics

Purpose: The aim of the present study was to investigate the difference in dynamic plantar pressure distribution changes in patients with degenerative knee arthrosis before and eight months after total knee arthroplasty (TKA) surgery.Materials and Methods: Patients with end stage gonarthrosis admitted to our clinic for TKA constituted the study group. An EMED SF-4 pressure sensitive platform was used to quantify the barefoot plantar pressures of the participants’ feet. Stance phase duration (ms), total plantar pressure (N/cm2) and centre of pressure (CoP) patterns during gait were recorded preoperatively and at 8th months postoperatively.Results: Fifteen knees of 13 patients who underwent primary TKA were included in the study. Stance phase durations in the pre- and postoperative periods were 987 ms and 801.5 ms, respectively. Total plantar pressures in the pre- and postoperative periods were 1257.75 N/cm2 and 1436.0 N/cm2, respectively. The difference in mediolateral plantar area was 0.69% in favor of lateral side of feet in the preoperative period and changed to 5.17% in favor of medial.Conclusion: For the surgical realignment of the knee, the kinematic chain of the lower extremity must be considered, and gait analysis will be helpful in deciding the type of surgical treatment.

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