Total Diz Artroplastisinde Kalça ve Diz Eklem Hareket Açıklığı ile Kas Kuvveti Ölçümünün Subjektif Fonksiyonel Sonuçlar Üzerine Etkisi

Amaç: Primer diz artroplastisi öncesi ve sonrası kas kuvveti ve eklem hareket açıklığı (range of motion, ROM) ölçümünün klinik sübjektif fonksiyonel skorlar ile korelasyonunu inceleyerek sübjektif fonksiyonel sonuçlar üzerindeki etkinliğini belirlemektir.Yöntemler: Primer diz artroplastisi uygulanan 26 hasta (23K/3E) prospektif olarak takip edildi. Ortalama yaş 67,3 yıl (aralık, 50-81 yıl), ortalama takip süresi 16 ay (aralık 6-24 ay). 14 (% 53,8) hastanın sol tarafı, 12 (% 46,2) hastanın ise sağ tarafı opere edildi.Operasyondan 1 gün önce ve postoperatif 6. ayda diz ve kalça ROM ve kas kuvveti ölçümleri yapıldı. ROM ölçümü için standart gonyometre kas kuvveti ölçümü için ise el dinamometresi kullanıldı. Ölçümlerle eş zamanlı olarak klinik sübjektif fonksiyonel değerlendirme için Amerikan Diz Cemiyeti (Knee Society Score, KSS) diz ve fonksiyon skoru ile Oxford Diz Skoru (Oxford Knee Score, OKS) kullanıldı. Hem preoperatif hem de postoperatif ölçümler ve skorlar arasındaki ilişki incelendi. İstatistiksel analiz için SPSS versiyon 21’de gruplar arası fark Student T ve Wilcoxon Testleri ile, korelasyon analizi ise Pearson ve Spearman testleri ile gerçekleştirildi.Bulgular: Post operatif dönemde pre operatif döneme göre tüm sübjektif fonksiyonel skorlamalarda, kalça fleksiyonunda ve fleksiyon kuvvetindeki artış anlamlı bulundu (p< 0.05). Postoperatif kalça fleksiyon, kalça ekstansiyon hareket açıklıkları ve preoperatif kalça abduksiyon kuvveti ile tüm postoperatif sübjektif fonksiyonel skorlamalar arasında pozitif korelasyon belirlendi (p< 0.05).Sonuç: Sonuç olarak bu çalışma ile total diz artroplastisinde postoperatif kalça fleksiyon açıklığı ve fleksiyon kuvvetinin fonksiyonel durumu diğer objektif ölçümlere göre daha iyi yansıttığı; ayrıca preoperatif kalça abduksiyon kuvvetinin postoperatif sübjektif iyileşme ile korele olduğu gözlendi.

Anahtar Kelimeler:

Diz artroplastisi, eklem hareket açıklığı, kas kuvveti, kalça, diz

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