Gelişimsel kalça displazisine bağlı koksartrozlu hastalarda total kalça artroplasti sonuçlarımız

GKD ülkemizde önemli bir sorun olarak hala yerini korumaktadır. Eğer erken teşhis edilip doğru tedavi edilemezse, genç erişkin ve ileri yaşlarda kalçada sekonder osteoartrite yol açmaktadır. Bu hastalığın tedavisinde proksimal femoral ve asetabular osteotomiler gibi değişik rekonstrüktif ameliyatlar uygulanmakta ise de fonksiyonel açıdan en tatmin edici sonuçlar total kalça artroplastisi ile alınmaktadır. Bu çalışmamızda gelişimsel kalça displazisine bağlı koksartrozlarda uygulanan çimentosuz total kalça artroplastisi sonuçlarımızı değerlendirdik. Ocak 2006 - Ekim 2009 tarihleri arasında gelişimsel kalça displazisine bağlı kalça osteoartriti olan toplam 53 hastanın 59 kalçasına TKA uygulanarak çalışmaya dahil edildi. Hastalarımızın 10'u erkek (% 19), 43'ü kadın (% 81) idi. Yaşları 29 ile 78 yaş arasında değişmekte olup ortalama yaş 48,7, ortalama takip süresi 20,6 ay idi. Toplam 10 (%17) komplikasyon gözlendi. Bu komplikasyonlardan 5'i (%8,5) ameliyat içi, 5'i (%8,5) ameliyat sonrası gelişti. Hastalar Modifiye Harris kalça skorlamasına göre ameliyat öncesi ve sonrası olmak üzere değerlendirildi. Ameliyat öncesi ortalama 39,1 olan Harris skoru ameliyat sonrası ortalama 90,3 olarak bulundu. Buna göre olguların 52'sinde(%88,1) mükemmel, 7 sinde (%11,9) çok iyi sonuç elde edilmiştir. Uygulama usulüne uygun olarak yapılır ise, kemik kalitesi iyi ve cerrahi endikasyonu olan GKD zemininde kalça osteoartritli hastalarda çimentosuz total kalça artroplastisi klinik ve radyolojik olarak oldukça tatminkar kısa dönem sonuçları vermektedir.

Total hip arthroplasty results due to developmental hip dysplasia

Developmental hip displasia (DHD) still presents as an important problem in our country. Latency in diagnosis and inaccurate treatment causes seconder osteoarthritis in young adults and elder patients. Variable reconstructive surgical procedures as proximal femoral and acetabular osteotomies can be performed, but the most satisfactory functional results are achieved by total hip arthroplasty [1]. In this study, we analyzed the results of the cementless total hip arthroplasties performed in coxarthrosis secondary to developmental hip displasia. Between January 2006 and October 2009, 53 patients diagnosed with hip osteoarthritis secondary to DHD, whom performed 59 total hip arthroplasties were included in the study. 10 of the patients were male (%19), and 43 of them were female (%81). Age of the patients varied between 29 and 78 years and the mean age was 48,7 mean follow-up period was 20,6 months. Totally 10 (%17) complications were observed. 5 (%8,5) of them was intraoperative and 5 (%8,5) was postoperative. While preoperative mean Harris score was 39,1, the postoperative mean score measured as 90,3. The results were excellent in 52 cases(%88,1), and very good in 7 cases(%11,9). Appropriate implementation of cementless total hip prosthesis in patients with hip osteoarthritis secondary to DHD, who have good bone quality and surgical indicaton; clinical and radiological short term results were satisfactory.

Kaynakça

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