Murat AŞCI, Orhan BALTA, M. Burtaç EREN, Recep KURNAZ, Taner GÜNEŞ

Medial Kompartman Artrozlu HastalarınTedavisinde Yüksek Tibial Osteotomi ve UnikondilerDiz Artroplastisinin Karşılaştırılması

İzole medial kompartman artrozunun cerrahi tedavisinde; unikompartmantal diz artroplastisi (UDP), yüksek tibial osteotomi (YTO) ve bazen de total diz artroplastisi (TDP) alternatif yöntemlerdir. Bu çalışmada benzer endikasyonları olan YTO ve UDP sonuçları klinik ve yaşam kalitesi açısından karşılaştırmalı olarak değerlendirilmiştir. Temmuz 2003 ve Şubat 2010 tarihleri arasında medialkompartman artrozu tanısı ile sirküler eksternalfiksatörle yüksek tibialosteotomi ve unikondiler diz artroplastisi yapılan toplam 47 hastanın 51 dizi çalışmaya alınmıştır. 31 hastanın (2 erkek, 29 kadın) 35 dizine sirküler eksternalfiksatörle YTO, 16 hastanın(16 kadın) 16 dizine UDP yapıldı. Hastalar; yaş, artroz derecesi, preoperatif ve postoperatif diz KSS, HSS ve SF-36 skorları açısından karşılaştırıldı. Ameliyat öncesi ve ameliyat sonrası değerler karşılaştırıldığında SF-36, HSS ve KSS skorlamaları açısından anlamlı farklılık saptanmadı. Her iki grubun ameliyat sonrası skorlarında anlamlı iyileşme elde edilirken, iyileşme miktarlarında iki grup arasında anlamlı fark saptanmadı. UDP grubunda (YTO grubuna göre) SF-36’nın ağrı ve emosyonel rol parametrelerinde daha hızlı ve daha fazla iyileşme elde edildiği görüldü. Klinik ve yaşam kalitesi değerlendirmelerinin sonuçları dikkate alındığında medial kompartman osteoartritinin tedavisinde her iki tekniğin de efektif ve memnuniyet verici olduğu görülmüştür.

Anahtar Kelimeler:

Gonartroz, Unikondiler diz protezi, tibial, osteotomi

Comparison of Unicondylar Knee Arthroplasty and High Tibial Osteotomy In Treatment of Medial Compartment Arthrosis

The surgical treatment alternatives for isolated medial compartmental knee osteoarthritis are high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA) and rarely total knee arthroplasty (TKA). In this study results of UKA and HTO are compared in regard to clinical results and quality of life. Between July 2003 and February 2010, 51 knees of 47 patients were operated for medial osteoarthritis of the knee. 35 knees of 31 patients (2 male and 29 female) underwent high tibial osteotomy using circular external fixator and 16 knees of 16 patients (16 female) underwent unicompartmental knee arthroplasty. The groups were compared according to age, degree of arthrosis, preoperative and postoperative HSS, KSS and SF-36 scores. There was no significant diffirence between the HTO and UKA groups in regard to SF-36, HSS and KSS parameters in preoperative and postoperative periods. Within each group there was significant increase in all parameters in the postoperative period, but there was no diffirence between the two groups. In UKA group the increase in pain and emotional role parameters of SF-36 were more prominent and rapid. In conclusion, in regard to clinical results and quality of life results both treatment modalities were effective and satisfactory in the treatment of medial compartmental knee osteoarthritis.

Keywords:

Gonarthrosis, Unicondylar Knee Prosthesis, Tibial, Osteotomy,

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