Köpeklerde sementsiz Pamuk's Total Kalça Protezi (PTKP) uygulanması ve sonuçlarının ilk değerlendirilmesi

Gereç ve Yöntem: Kalça problemi olan (displazi, çıkık ve kırık) 12adet köpek değerlendirildi. Kalça protez ekipmanı (Ortho-Pet), İzmir(Türkiye)de imal edilmiştir. Kalça ekleminin craniodorsal yüzünetrochanter major düzeyinde, craniolateral ensizyonla yaklaşıldı. Caput femorisin eksizyonundan sonra acetabulum genişletildi. Acetabular komponent yerleştirildikten sonra vidalarla sabitlendi. Dahasonra collum femorise femur komponenti yerleştirildi. İmplant başı,implantın boyun kısmının üzerine çakılarak, kalça eklemi yerine yerleştirildi. Operasyondan sonra 15. gün ile 1, 3 ve 6. aylarda inspeksiyon, palpasyon ve radyografik muayeneler yapıldı. Bulgular: Yedi köpekte (%58.3) postoperatif dönemde prognozun iyi ve çok iyi olduğu görüldü. Prognozu iyi olan olguların klinikmuayeneleri 15 ve 30. günde birbirlerine benzerlikler gösterirken,post-operatif 90. günde ise post-operatif 15 ve 30. günde yürüyüşproblemlerinin ortadan kalktığı ve ekstremitenin istenildiği gibi kullanıldığı tespit edildi. 5 köpekte (%41.6) ise ekstremitenin iyi kullanılamadığı ve çeşitli derecelerde topallıkları olduğu gözlendi. Buolgularda radyografik muayenelerde collum femoris aparatının gevşemesi, sublukzasyon ve acetabular komponentin acetabulum içinetam sabitlenmediği tespit edildi.Öneri: Sementsiz PTKPnin ilk sonuçlarında bazı teknik problemlergörülmesine rağmen köpeklerde kalça problemlerinde ekonomik,geliştirilebilecek ve sonuçlarının cesaret verici olması açısından yararlı olduğu ifade edilebileceği kanısına varıldı. Ayrıca, PTKPnin 6aydan daha uzun dönem sonuçlarının takip edilmesi kullanılabilirliği ve geliştirilebilirliği açısından önemli bilgiler vereceği düşünülmüştür.

Implementation of cementless Pamuk's Total Hip Replacement (PTKP) in dogs, and first evaluation of the results.

Materials and Methods: Twelve dogs with hip problems (dyspla- sia, luxations and fractures) were used. Equipment, Ortho-Pet, Izmir(Turkey) were manufactured. It was approached with craniolateralincision of craniodorsal sides of the hip trochanter major level. Caputfemoris excision was performed by osteotomy. And then, acetabulumwas enlarged. After acetabular cup have placed and it was fixed withscrews. Then the implants was placed for collum femoris. Implanthead of the neck portion was steeled and the hip joint was in place.In controls, inspection, palpation and radiographic examination wasperformed for post-op 15 days and 1, 3 and 6 months.Results: Seven dogs (58.3%) in the postoperative prognosis is seengood or very good condition. Clinical examination of patients with agood prognosis in 15th and 30th days showed similarities betweeneach other. Comparison of post-operative 90th days with 15th and30th day prognosis show that the gait problems was eliminated andto considered to be very good condition. It was also observed thatthe extremities used as intended. The extremities were not used verywell and lameness of varying degrees in 5 dogs (41.6%). Radiogra- hic examination of these dogs were showed loosening of the collumfemoris apparatus, subluxation and the acetabular components maynot fixed into the acetabulum properly. Conclusion: Although the first impression of cementless PTKP s wasshown some technical problems, it has been concluded that it is eco- nomic, development devices and encouraging of the first results. Inaddition, monitoring of longer-term outcomes PTKP s more than 6months is thought to provide important information for the availa- bility and development.

PDF

___

Allen MJ, 2012. Advances in total joint replacement in small animals. J Small Anim Pract, 53, 495-506.
Andrews CM, Liska WD, Roberts DJ, 2008. Sciatic neurapra- xia as a complication in 1000 consecutive canine total hip replacements. Vet Surg, 37, 254-262.
Bergh MS, Gilley RS, Shofer FS, Kapatkin AS, 2006. Complica- tions and radiographic findings following cemented total hip replacement. Vet Comp Orthop Traumatol, 19, 172- 179.
Bergh MS, Muir P, Markel MD, Manley PA, 2004. Femoral bone adaptation to stable long term cemented total hip arthroplasty in dogs. Vet Surg, 33, 214-220.
Bessette BJ, Fassier F, Tanzer M, Brooks CE, 2003. Total hip arthroplasty in patients younger than 21 years: A mini- mum, 10-year follow-up. Can J Surg, 46, 257-262.
Birkenhauer B, Kistmacher H, Ries J, 2004. Conception and first results of the Spiron cementless femoral neck screw prosthesis. Orthopade, 33, 1259-1266.
Bleyaert H, 2003. Zürich Cementless Total Hip Prothesis. Re- view the Critical Care AVS Florida Veterinary Specialists, pp: 9-12.
Bobyn JD, Mortimer ES, Glassman AH, Engh CA, Miller JE, Brooks CE, 1992. Producing and avoiding stress shielding. Laboratory and clinical observations of noncemented total hip arthroplasty. Clin Orthop Relat Res, 274, 79-96.
Boudrieau R, 2003. Clinical evalution of the Zurich Cement- less Hip System. Proceedings of 13th Annual American College of Veterinary Surgeons Forum, Washington, USA, pp: 569-573.
Clohisy JC, Oryhon JM, Seyler TM, Wells CW, Liu SS, Callag- han JJ, Mont MA, 2010. Function and fixation of total hip arthroplasty in patients 25 years of age or younger. Clin Orthop Relat Res, 468, 3207-3213.
Çaptuğ Ö, Bilgili H, 2006. Köpeklerde kalça displazisine gün- cel yaklaşımlar. Kalça displazisinin etiyolojisi ve patogene- zisi. Erciyes Üniv Vet Fak Der, 3, 123-128.
Çetinkaya MA, Olcay B, 2006. Köpeklerde total kalça artrop- lastisi: Bölüm 1. Vet Cer Der, 12, 92-96.
Denny HR, Butterworth SH, 2000. A quide to canine and feli- ne orthopaedic surgery. Blackwell Science, 4th edition, UK, pp: 459-467.
DeYoung DJ, DeYoung BA, Aberman HA, Kenna RV, Hunger- ford DS, 1992. Implantation of an uncemented total hip prothesis, techniques and initial results of 100 arthroplas- ties. Vet Surg, 21, 168-177.
DeYoung DJ, Schiller RA, 1992. Radiographic criteria for eva- luation of uncemented total hip replacement in dogs. Vet Surg, 21, 88-98.
Dyce J, Wisner LR, Schrader SC, Wang Q, Olmstead ML, 2001. Radiograhic evaluation of acetabular component position in dogs. Vet Surg, 30, 28-39.
Dyce J,Wisner ER, Wang Q, Olmstead ML, 2000. Evaluation of risk factors for luxation after total hip replacement in dogs. Vet Surg, 29, 524-532.
El-Warrak AO, Olmstead ML, von Rechenberg B, Auer JA, 2001. A review of aseptic loosening in total hip arthrop- lasty. Vet Comp Orthop Traumatol, 14, 115-124.
Finkbone PR, Severson EP, Cabanela ME, Trousdale RT, 2012. Ceramic-on-ceramic total hip arthroplasty in patients yo- unger than 20 years. J Arthroplasty, 27, 213-219.
Fossum TW, 2013. Small Animal Surgery, Fourth Edition, El- sevier, London, UK, pp: 1309-1311.
Frankel DJ, Pluhar GE, Skurla CP, Egger EL, James SP, 2004. Radiographic evaluation of mechanically tested cemented total hip arthroplasty femoral componets retrieved post- mortem. Vet Comp Orthop Traumatol, 17, 216-224.
Guerrero TG, Montavon PM, 2009. Zurich cementless total hip replacement: retrospective evaluation of 2nd genera- tion implants in 60 dogs. Vet Surg, 38, 70-80.
Hach V, Delfs G, 2009. Initial experience with a newly deve- loped cementless hip endoprosthesis. Vet Comp Orthop Traumatol, 14, 153-158.
Hanson SP, Peck JN, Berry CR, Graham J, Stevens G, 2006. Ra- diographic evaluation of the Zurich cementless total hip acetabular component. Vet Surg, 35,550-558.
Hedley AK, Kabo M, Kim W, Coster I, Amstutz HC, 1983. Bony ingrowth fixation of newly designed acetabular compo- nents in a canine model. Clin Orthop Relat Res, 176,12-23.
Hozack WJ, Rothman RH, Booth RE Jr, Balderston RA, 1993. Cemented versus cementless total hip arthroplasty. A com- parative study of equivalent patient populations. Clin Ort- hop Relat Res, 289,161-165.
Huggler AH, Jakob HAC, 1995. Die Entwicklung der Drucks- cheibenprothese (DSP), in: Endoprothetik, Ed: Morscher EW, Springer, New York, USA, pp: 267-278.
Kim YH, Oh SH, Kim JS, 2003. Primary total hip arthroplasty with a second-generation cementless total hip prosthesis in patients younger than fifty years of age. J Bone Joint Surg Am. 85,109-114.
Krebs J, 2002. In vivo comparison of the biological attach- ment characteristics of titanium and hydroxyapatite coa- ted implants. Vet Diss Universitat Bern, Germany.
Liska WD, 2004. Femur fractures associated with canine total hip replacement. Vet Surg, 33, 164-172.
Lockwood AA, Liska WD, 2011. Duration of clinical signs pri- or to total hip replacement in dogs. J Am Vet Med Assoc, 1, 905-908.
Marcellin-Little DJ, 2006. BFX cementless total hip arthrop- lasty. Proceeding of 2nd World Veterinary Orthopedic Congress, Keystone, USA pp: 101-102.
Marcellin-Little DJ, DeYoung DJ, Thrall DE, Merrill CL, 1999. Osteosarcoma at the site of bone ınfarction associated with total hip arthroplasty in a dog. Vet Surg, 28: 54-60.
Massat BJ, 1995. Canine Cemented Total Hip Arthroplasty, Waltham Focus, volume 5, no.4, Massachusetts, USA, pp: 21-31.
Massat BJ, Vasseur PB, 1994. Clinical and radiographic re- sults of total hip arthroplasty in dogs: 96 cases (1986- 1992). J Am Vet Med Assoc, 205: 448-454.
Montavon PM, Tepic S, 2000. Clinical application of Zurich cementless-canine total hip prosthesis. Vet Comp Orthop Traumatol, 13, 3.
Nelson LL, Dyce J, Shott S, Shott S, 2007. Risk factors for vent- ral luxation in canine total hip replacement. Vet Surg, 36, 644-653.
Olmstead ML, 1987. Total hip replacement. Vet Clin North Am Small Anim Pract, 17, 943-955.
Olmstead ML, 1998. Total Hip Replacement, in: Current Tech- niques in Small Animal Surgery, Williams & Wilkins, Balti- more, UK, pp: 1173-1178.
Olmstead ML, Hohn RB, Turner TM, 1983. A five-year study of 221 total hip replacements in the dog. J Am Vet Med As- soc, 183,191-194.
Ota J, Cook JL, Lewis DD, Tomlinson JL, Fox DB, Cook CR, Schultz LG, Brumitt J, 2005. Short term aseptic loosening of the femoral component in canine total hip replacement: Effects of cementing technique on cement mantle grade. Vet Surg, 34, 345-352.
Özsoy S, Mutlu Z, Erdikmen DO, Altunatmaz K, 2011. Using total hip prosthesis with porous-coated and ınterlocking system in twenty-one dogs. Kafkas Univ Vet Fak Derg, 17, 941-948.
Piermattei DL, Johnson KA, 2004. Arka bacak. M. Arıcan, in: Kemik ve Eklemlere Cerrahi Yaklaşım Atlası (çeviri), Eds; Okumuş Z, Kaynak M, Dördüncü Baskı, Medipress, Malatya, Türkiye, pp: 329-338.
Preston CA, Schulz KS, Vasseur PB, 1999. Total hip arthrop- lasty in nine canine hind limb amputees: A retrospective study. Vet Surg, 28, 341-347.
Schulz KS, 2000. Application of arthroplasty principles to canine cemented total hip replacement. Vet Surg, 29, 578- 593.
Schulz KS, Loic M, 2004. Surgical Treatment of Canine Hip Dysplasia Total Hip Arthroplasty, in: Textbook of Small Animal Surgery, 3. Baskı. WB Saunders, Philadelphia, USA, pp: 2046-2059.
Skurla CP, James SP, 2004. Postmortem retrieved canine THR femoral and acetabular component interaction. Biomed Sci Instrum, 40, 255-260.
Skurla CP, Pluhar GE, Frankel DJ, Egger EL, James SP, 2005. Assessing the dog as amodel for human total hip repla- cement. Analysis of 38 canine cemented femoral compo- nents retrieved at post-mortem. J Bone Joint Surg Br, 87, 120-127.
Torchia ME, Klassen RA, Bianco AJ, 1996. Total hip arthrop- lasty with cement in patients less than twenty years old. Long-term results. J Bone Joint Surg Am, 78, 995-1003.