ALPASLAN ÖZTÜRK, MÜHAMMET SADIK BİLGEN, TEOMAN ATICI, Özgür ÖZER, Ömer Faruk BİLGEN

Total diz protezi uygulamalarında patella eklem yüzeyi değiştirilen ve değiştirilmeyen olguların değerlendirilmesi

Amaç: Total diz protezi (TDP) uygulamalarında patella eklem yüzeyinin değiştirilmesinin ve değiştirilmemesinin klinik ve radyografik sonuçlara etkisi değerlendirildi. Çalışma planı: Primer diz osteoartriti nedeniyle TDP uygulanan ve yeterli takibi olan 126 hastanın 149 dizi incelendi. Elli dokuz dizde (grup 1) patella eklem yüzeyi değiştirilirken, 90 dizde (grup 2) değiştirilmedi. Klinik değerlendirmede KSS (Knee Society Score) diz ve fonksiyon puanları ve patella puanı, radyografik değerlendirmede eklem çizgisinin yer değiştirme miktarı, Insall-Salvati oranı, lateral patellofemoral açı ve uyum açısı kullanıldı. Grup 1’de ortalama takip süresi 66.7 ay (dağılım 34-123 ay), grup 2’de ise 68.1 ay (dağılım 30-117 ay) idi. Sonuçlar: Her iki grupta da, ameliyat öncesine göre ameliyat sonrası diz ve fonksiyon puanları anlamlı derecede düzelmesine (p0.05). Patella puanlama sistemiyle yapılan değerlendirmede de iki grubun ameliyat sonrası puanları anlamlı farklılık göstermedi (p>0.05). Ameliyat sonrası radyografik değerlendirmede, iki grup arasında dizlerin mekanik aks değerleri, patellar tilt ve lateral subluksasyon açısından anlamlı fark bulunmadı (p>0.05). Her iki grupta da ameliyat sonrasında patellanın semptomatik subluksasyonu, dislokasyonu, kırığı ve ekstansör mekanizma yırtığına rastlanmadı; patella veya patellar protezle ilgili revizyon yapılmadı. Çıkarımlar: Patella eklem yüzeyinde ileri derecede dejeneratif değişikliği olan olgular dışında, patella eklem yüzeyinin değiştirilmemesinin uygun olacağı kanısındayız.

Anahtar Kelimeler:

Artroplasti, replasman, diz, Diz protezi, Patella, Osteoartrit, diz

The evaluation of patients undergoing total knee arthroplasty with or without patellar resurfacing

Objectives: We evaluated the clinical and radiographic results of total knee arthroplasty (TKA) with or without patellar resurfacing. Methods: The study included 149 knees of 126 patients who underwent TKA for primary knee osteoarthritis with (59 knees, group 1) or without (90 knees, group 2) patellar resurfacing. Clinical evaluations were made with the knee and function scores of the Knee Society, and patella scoring system; radiographic evaluations included changes in the joint line, Insall-Salvati ratio, lateral patellofemoral angle, and congruency angle. The mean follow-up period was 66.7 months (range 34 to 123 months) in group 1, and 68.1 months (range 30 to 117 months) in group 2. Results: Although postoperative knee and function scores showed significant improvements in both groups (p0.05). The mean patella scores did not differ significantly, either (p>0.05). Postoperative radiographic assessments did not show significant differences between the two groups with respect to mechanical axis values, patellar tilt, and lateral subluxation (p>0.05). Symptomatic patellar subluxation, dislocation, fracture or rupture of the extensor mechanism did not occur in any of the treatment groups. None of the patients required revision associated with the patella and patellar prosthesis. Conclusion: Our findings suggest that patellar resurfacing is not necessary other than patients with significant degeneration of the patellar surface.

Keywords:

Arthroplasty, Replacement, Knee, Knee Prosthesis, Patella, Osteoarthritis, Knee,

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