Şehmuz KAYA, Hüseyin ÖZDEMİR, Abdullah Yalçın DABAK

İleri Yaş Hastalarda Çimentolu ve Çimentosuz Hemiartroplasti Sonuçlarının Karşılaştırılması

Amaç: Bu çalışmada ileri yaş hastalarda çimentolu ve çimentosuz hemiartroplasti sonuçlarını ve birbirine üstünlüklerini değerlendirdik. Yöntemler: Bu çalışma femur boyun kırığı nedeni ile takip edilen ve hemiartroplasti cerrahisi uygulanan toplam 86 hastadan düzenli kontrollere gelip kayıtları tutulan 46 hastanın dahil edildiği retrospektif bir çalışmadır. Bu hastaların 28'ine çimentosuz, 18'ine çimentolu hemiartroplasti yapılmıştı. Bulgular: Çimentosuz hemiartroplasti operasyonu yapılmış hastaların ortalama yaşı 71,3 (yaş aralığı 50-94), çimentolu hemiartroplasti yapılmış grupta ise 86 (yaş aralığı 58-104)' tü. Broker'in myoziti değerlendirmek için tarif ettiği sınıflandırmaya göre çimentolu bipolar hemiartroplasti yapılan 10 (%55,5) hastada myozit görüldü. Çimentosuz bipolar hemiartroplasti yapılan 6 (%21,4) hastada myozit görüldü. Çimento uygulanan 18 hasta ile uygulanmayan 28 hasta arasında harris skoru açısıdan anlamlı fark yoktu (p=0.339). Ayrıca iki grup arasında femoral stem gevşemesi ve stem migrasyonu açısından anlamlı fark yoktu (p> 0.05). Heterotropik ossifikasyon açısından iki grup arasındaki fark ise anlamlı idi (p< 0.05). İki grup arasındaki perioperatif mortalite oranları karşılaştırıldığında sementli hemiartroplasti yapılan grupta mortalite oranları daha yüksek bulunmuştur. Sonuç: İleri yaştaki hastalarda sementsiz kalça protezinin özellikle ameliyat esnasında hastaya minimum travma yaşatması, mortaliteyi anlamlı bir şekilde düşürmesinden dolayı bu hastalarda en uygun tedavi yöntemi olduğunu düşünmekteyiz.

Comparison of the Advantages of Cemented and Cementless Hemiarthroplasty Outcomes in Elderly Patients

Objective: In this study, we evaluated advantages of each and cemented and cementless hemiarthroplasty results in older patients. Method: This study is a retrospective study included 46 patients came to regular controls from a total of 86 patients who underwent hemiarthroplasty surgery and followed because of femoral neck fracture. Of these patients, 28 cementless and 18 cemented hemiarthroplasty were enrolled for the study and were then classified into two groups. Results: The average age of patients with cementless hemiarthroplasty operations was 71.3 years , while the average age of patients with cemented hemiarthroplasty was 86 years . According to the Broker classification described to evaluate myositis, in 10 (55.5%) patients who made cemented bipolar hemiarthroplasty was seen myositis. In 6 (21.4%) patients who made cementless bipolar hemiarthroplasty was 6 (21.4%) was seen myositis. Among 18 patients who applied cement with 28 patients who not applied cement was no significant difference in Harris score (p=0.339). In addition, between the two groups was no significant difference in terms of femoral stem loosening and stem migration (p< 0.05). The difference between the two groups in terms of heterotopic ossification was significant (p< 0.05). Perioperative mortality rate was significantly higher in cemented hemiarthroplasty. Conclusion: The cementless hip prosthesis in elderly patients has minimal trauma during surgery. Mortality is also low. Therefore, we believe that the cementless hip prosthesis in elderly patients is most appropriate therapy.

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