Vahit YILDIZ, Ali ŞİŞMAN, Caner POYRAZ, Halil YILDIRIM, Kadri YILDIZ, Sevki Oner SAVK

Koksartrozlu Kalçada Gelişen Kompleks Asetabuler Kırığın Tedavisinde Erken ve Geç Dönem Artroplasti Sonuçlarinin Değerlendirilmesi

ÖZET Amaç: Bu çalışmada koksartrozu mevcut olup kompleks asetabulum kırığı nedeniyle erken ve geç kalça artroplastisi yapılan hastaların klinik sonuçlarını karşılaştırmayı ve klinik sonuçları etkileyen faktörleri araştırmayı amaçladık. Yöntem: 2005 ve 2017 yılları arasında asetabular kırık nedeniyle ameliyat edilen hastalar geriye dönük olarak incelendi. Letournel Sınıflamasına göre kompleks kırıklar ve Kellgren-Lawrence radyolojik kriterlerine göre artrozu olan hastalar, çalışmaya dahil edildi. Hastalar artroplasti yapılma zamanlarına göre kırık sonrası erken dönem (grup 1) ve geç dönem (grup 2) olmak üzere iki gruba ayrıldı. Her iki grup Harris kalça skoru, Visual Analogue Scale (VAS), yaş, artroz, ameliyat süresi ve günlük hayata dönme süresi açısından karşılaştırıldı. Bulgular: Çalışmaya alınan hastaların 20'sinin erken dönemde, 21'inin ise geç dönemde artroplasti geçirdiği belirlendi. Ortalama Harris skoru erken artroplasti yapılanlarda 71.60 (± 13.5), geç artroplasti yapılanlarda 61.23 (± 2.6) idi (p = 0.002). Ortalama VAS skoru erken artroplasti yapılanlarda 1.7 (1-3), geç artroplasti yapılanlarda 2.6 (1-5) idi (p = 0,102). Sonuç: Erken artroplasti, koksartroz zemininde kompleks asetabular kırığı olan hastalarda geç artroplastiye göre daha iyi fonksiyonel sonuç ve daha düşük komplikasyon oranları ile daha güvenli bir seçenektir. Koksartroz zemininde kompleks asetabular kırığı olan hastalarda, cerrahın erken veya geç artroplasti kararında arada kaldığı durumlarda, erken artroplasti tercih edilmelidir. Anahtar Kelimeler: Asetabular kırık, koksartroz, total kalça replasmanı

Anahtar Kelimeler:

koksartroz, asetabulum kırığı, total kalça protezi

Evaluation of Early and Late Period Arthroplasty Results in the Treatment of Incomplex Acetabular Fractures with Coxarthrosis

Purpose: We aimed to compare the clinical results of patients who underwent early and late hip arthroplasty due to complex acetabulum fracture with coxarthrosis and investigate the factors affecting the clinical results. Method: Patients who were operated on for acetabular fractures between 2005 and 2017 were retrospectively analysed. Patients with complex fractures according to the Letournel Classification and arthrosis according to the Kellgren-Lawrence radiological criteria were included in the study. Patients were divided in to two groups, post-fracture early period (group 1) and late period (group 2), based on when they underwent arthroplasty. Both groups were compared in terms of Harris hip score, Visual Analogue Scale (VAS), age, arthrosis, operation time, and time to return to daily life. Result: It was determined that 20 of the patients included in the study underwent arthroplasty in the early period and 21 in the late period. The mean average Harris score was 71.60 (± 13.5) in those who underwent early arthroplasty and 61.23 (± 2.6) in those who underwent late arthroplasty (p = 0.002). The average VAS score was 1.7 (1–3) in those who underwent early arthroplasty and 2.6 (1–5) in those who underwent late arthroplasty (p= 0.102) Conclusion: Early arthroplasty is a safer option with better functional results and lower complication rates than late arthroplasty in patients with complex acetabular fractures with coxarthrosis. In patients with complex acetabular fractures with coxarthrosis, early arthroplasty should be preferred when the surgeon is not sure about early or late arthroplasty. Keywords: Acetabular fracture, coxarthrosis, total hip replacement.

Keywords:

coxarthrosis, acetabular fracture, total hip arthroplasty,

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