Tolga ATAY, Nevres Hürriyet AYDOĞAN, Osman Gazi AKSOY

Hareketli polietilen insertli ve sabit polietilen insertli diz protezi uyguladığımız hastaların orta dönem sonuçlarının değerlendirilmesi

Son yıllarda protez tasarımlarında ve cerrahi tekniklerde kaydedilen gelişmeler neticesinde diz artroplastisinde başarılı sonuçlar elde edilmiştir. Bu gelişmeler sonucunda farklı protez tasarımları ortaya çıkmıştır. Hareketli ve sabit insertli diz protezlerinin her iki tipiyle de başarılı klinik sonuçlar elde edilebilmektedir. Çalışmamızda şubat 2001 ve mart 2003 tarihleri arasında 53 hastanın 54dizine hareketli ve sabit insertli diz protezi uygulanarak, bu vakaların orta dönem sonuçları değerlendirdik. Hastalarımızın, preoperatif ve postoperatif dönemde klinik değerlendirmeleri, Diz Cemiyeti tarafından önerilen değerlendirme sistemine göre yapıldı(1-3). Preoperatif değerlendirmede ortalama diz ve fonksiyon skorları arasında gruplara göre anlamlı bir farklılık gözlenmedi. (Mann-Whitney U testi, p>0.05). Hastaların postoperatif sonuçlarını karşılaştırdığımız zaman her iki grup arasında yine anlamlı bir fark yoktu, fakat hareketli insertli diz protezlerinin diz ve fonksiyon skorları daha yüksek bulundu. (Mann-Whitney U testi, p>0.05). Postoperatif radyolojik değerlendirmede hareketli ve sabit polietilen insertli diz protezi uyguladığımız hastalarımızın hiçbirinde gevşeme bulgularına rastlamadık. Sonuç olarak her iki diz protezinin orta dönem klinik sonuçları arasında istatistiksel olarak anlamlı bir fark olmasa da hareketli insertli diz protezlerinin klinik sonuçlarının daha iyi olduğu kanısına ulaştık.

The evaluation of the midterm results of the patients applied knee prosthesis with polyethylene mobile bearing and fixed bearing insert

Recent years there have been successful results on knee arthroplasty because there have been improvements on designs of the prosthesis and surgical techniques. Because of these improvements different prosthesis designs have appeared. Successful results have been able to be achieved with the knee prosthesis with both mobile bearing and fixed bearing insert. In our study, we evaluated the midterm results of 53 patients, whose 54 knees, we applied knee prosthesis with mobile bearing and fixed bearing insert between February 2001 and March 2003. In the preoperative and postoperative periods the clinical evaluations of our patients were done according to the evaluation system suggested by Knee Society. In the preoperative evaluation, there were not dramatic differences between the average scores of knee and function according to the groups (Mann-Whitney U test, p>0.05). When we compared the postoperative results of the patients, again there were no dramatic differences between the two groups but it was found that the scores of knee and functions of knee prosthesis with mobile bearing insert were high (Mann-Whitney U test, p>0.05). In the radiological evaluation of postoperative period we did not see any loose symptoms on any of our patients in both groups. In conclusion, statistically there was not a dramatic difference between the midterm

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1. Ewald FC, Jacobs MA, Miegel RE. Kinematic total knee replecement. J.Bone Joint Surg 1984;66- A:1032.
2. Insall JN, Lachiewicz PF, Burstein AH. The posterior stabilized condylar prosthesis. J.Bone Joint Surg 1982;64 A:1317.
3. Insall JN, Dorr LD, Scott RD. Rationale of the knee society clinical rating system. Clin. Orthop 1989;13:248.
4. Sorrells RB. The Rotating Platform mobile bearing total knee arthroplasty. Surgical Technology International IX San Francisco;2000.
5. Buechel FF.Twenty-year evaluation of meniscal bearing and rotating platform knee replacements. Clinical Orthopaedics and Related Research 2001;41-50.
6. Collier J, Mayor MB, McNamara JL, Supernant BA, Jensen RE. Analysis of the failure of 122 polyethylene inserts from uncemented tibial knee components. Clin. Orthop. and Related. Resarch 1993;273.
7. Pappas MJ, Makris G, Buechel FF. Wear performance in total knee replacements: An experimental study. Depuy Inc. data on file.1992;Feb.
8. D’ Lima DD, Trice M. Comprasion between kinematics of fixed and rotating bearing knee prostheses. Clinical Orthopedics and Related Research 2000;330:151-157.
9. Stukenborg CC, Stermeier S, Wirth JC. Tibiofemoral contact stress after total knee arthroplasty, Acta. Orthop. Scand 2002;73: 638-646.
10. Callaghan JJ. Mobile-bearing knee replacement: Clinical results. Clinical Orthopedics and Related Research 1992;392:221-225.
11. Emerson HR, Hansborough T, Reidman RD. Comparison of a mobile with a fixed bearing unicompartmental knee implant. Clinical Orthopeadics and Related Research 2002;404:82-70.
12. Kim YH, Kook HK, Kim JS. Comparision of fixed bearing and total knee arthroplasties. Clin. Orthop 2002;404:62-70.
13. Chi KY, Ng TP, Tang WM, Lam P. Bilateral total knee arthroplasty one mobile bearing and fixed bearing. Journal Ortop. Surgery 2001;9:45-50.