Aynı ve ayrı seanslarda uygulanan çimentosuz bilateral TKP sonuçlarının karşılaştırılması
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Date
2001
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Uludağ Üniversitesi
Abstract
Aynı ve ayrı seanslarda bilateral çimentosuz Total Kalça Protezi (TKP) uygulanan olguların klinik ve radyolojik sonuçları karşılaştırıldı. Bilateral çimentosuz TKP uygulanan 40 hasta retrospektif olarak incelendi. Aynı seansta bilateral çimentosuz TKP uygulanan (Grup A) 16 hastanın 11'i (&68. 7) kadın, 5 'i (%31. 3) erkek ve yaş ortalaması 52.8 yıl (26-68 yıl) olup takip süresi 26.4 ay (19-35 ay) iken ayrı seanslarda çimentosuz bilateral TKP uygulanan (Grup B) 24 hastanın I6'sı (%66. 6) kadın, 8 'i (%33.4) erkek ve yaş ortalaması 49.6 yıl (20-72 yıl) olup takip süresi 35.8 ay (25-74 ay) idi. Grup A ve B 'de cinsiyet, tanı ve ameliyat öncesi risk faktörleri yönünden anlamlı bir fark yoktur (P> 0.005). Harris kalça puanı grup A 'da ameliyat öncesi ortalama 42 (30-60), ameliyat sonrası ortalama 92 (82-100) iken grup B'de sırasıyla 46.5 (34-62), 90.8 (78-100) olarak hesaplanmış olup bu değerlerde yüzde değişim olarak anlamlı farklılık saptandı (P< 0. 005). Grup A hastalarda takip süresi ortalama 22.4 ay (1 2-32 ay), ameliyat süresi ortalama 263 dakika (225-360 dk), ameliyat sırasında kanama miktarı ortalama 893 ml (450-1500 ml), ameliyat sonrası drenlerden toplanan kanama miktarı ortalama 687.5 ml (350-1300 ml), ameliyat sırasında kan transfüzyon miktar ortalama 3.0 ünite (2-5 Ü), ameliyat kan transfüzyon miktarı 2.12 ünite (0-5 Ü) ve hastanede kalış süresi ortalama 15.5:6.25 gün (6-28 gün) olarak tespit edilirken grup B hastalarda ilk kalça ameliyat edildikten ortalama 8 ay (1-17 ay) sonra diğer kalça ameliyat edilmiş olup her iki kalçada ameliyat edildikten sonra ortalama takip süresi 35.8 ay (1 4-70 ay) dır. Grup B 'de ortalama ameliyat süresi 282 dakika (200-360 dk), ameliyat sırasında kanama miktarı ortalama 910 ml (550-I350 ml), ameliyat sonrası dren lerde toplanan kanama miktarı ortalama 689 ml (100-1 200 ml), ameliyat sırasında kan transfüzyon miktarı ortalama 4.25 ünite (2-7 Ü), ameliyat sonrası kan transfüzyon miktarı ortalama 2.3 ünite (1 -4 Ü) ve hastanede kalış süresi ise ortalama 19.3:t5.1 gün (12-31 gün) olarak tespit edilmiştir. Kanama miktarı açısından değerlendirildiğinde iki grup arasında istatistiksel olarak anlamlı fark saptanmadı (P>0.005). Radyolojik olarak tüm komponentler stabil olarak değerlendirildi. Komplikasyon olarak grup A 'da 1(%6.25) olguda pnömoni, 1 (%6.25) olguda yüzeyel enfeksiyon gelişti; grup B'de ise 2 (%8.2) olguda yüzeyel enfeksiyon:1(%4. 1) olguda gelişen üriner enfeksiyon. antibiyotik tedavisiyle sorunsuz iyileşti. Grup B 'de ameliyat sırasında oluşan stage femoral kırık kablo ile tespit edildi ve sorunsuz iyileşti. Aynı seansta yapılan çimentosuz bilateral TKP uygulamaları ayrı seanslarda yapılan uygulamalar ile eş güvenilirlik. Ameliyat sonrası erken yük vermenin protez stabilitesine olumsuz etkisi olmamıştır.
The elinical and radiologic results of patients who underwent in one or two-stage total hip· arthroplasty were compared. A retrospective study was carried out in 40 patients undergoing bilateral cementless THA performed with a proximally anchored straight femoral shaft prosthesis (BİCONTACT). Of 16 patients performed one-stage THA, 11 (68.7%) were female, 5 (31.3%) were male and mean age 52.8 years (26-68) and the follow-up period was 22.4 months white in;24 two-stage patients, I6 (66.6%) were female, 8 (33.4%) were male and mean age 49.6 years (20-72) and the follow-up period was 35.8 months (14-70). Demographics were similar for both groups (P>0.05). When in one and two stage patients Harris hip score percentage variations were compared, variations in one-stage patients were statistically high (P<0.05). In one and two stage patients amount of total bleeding was mean 1580.5 ml (1000-2050), 1599.5 ml (975-2100) respectively (P>0.005). In one-stage patients amount of total blood transfusion was mean 5.1 ünits (3-7), in two-stage patients it was 6. 7 ünites (3-8) and a statistically significant difference was established (P<0.05). In one and two stage patients duration of operation was 263 minules (225-360), 282 minules (200-360) respectively (P>0.05). Hospital stay in one-stage patients was mean 15.5:6.25 day, 19.3-5.19 day in two-stage patients and this duralian was significantly high in two-stage patients (P<0.05). Radiographically, all components were stable without evidence of significant subsidence. Postoperative physical therapy and rehabilitation regimes were identical for both groups with full weight bearing encouraged on the first postoperative day. In one-stage patients pneumonia in 1 case (%6. 25), superficial infection in 1 case (%6.25) and in 2 cases (%8. 2) superficial infection, in 1 case (%4.1) urinary infection, in 1 case (%4.1) stage 1 femoraljissure in two-stage patients developed. A one-stage cementless bilateral THA is as safe as a two-stage procedure. After operation full weight bearing did not have any adverse effect on stability of prosthesis.
The elinical and radiologic results of patients who underwent in one or two-stage total hip· arthroplasty were compared. A retrospective study was carried out in 40 patients undergoing bilateral cementless THA performed with a proximally anchored straight femoral shaft prosthesis (BİCONTACT). Of 16 patients performed one-stage THA, 11 (68.7%) were female, 5 (31.3%) were male and mean age 52.8 years (26-68) and the follow-up period was 22.4 months white in;24 two-stage patients, I6 (66.6%) were female, 8 (33.4%) were male and mean age 49.6 years (20-72) and the follow-up period was 35.8 months (14-70). Demographics were similar for both groups (P>0.05). When in one and two stage patients Harris hip score percentage variations were compared, variations in one-stage patients were statistically high (P<0.05). In one and two stage patients amount of total bleeding was mean 1580.5 ml (1000-2050), 1599.5 ml (975-2100) respectively (P>0.005). In one-stage patients amount of total blood transfusion was mean 5.1 ünits (3-7), in two-stage patients it was 6. 7 ünites (3-8) and a statistically significant difference was established (P<0.05). In one and two stage patients duration of operation was 263 minules (225-360), 282 minules (200-360) respectively (P>0.05). Hospital stay in one-stage patients was mean 15.5:6.25 day, 19.3-5.19 day in two-stage patients and this duralian was significantly high in two-stage patients (P<0.05). Radiographically, all components were stable without evidence of significant subsidence. Postoperative physical therapy and rehabilitation regimes were identical for both groups with full weight bearing encouraged on the first postoperative day. In one-stage patients pneumonia in 1 case (%6. 25), superficial infection in 1 case (%6.25) and in 2 cases (%8. 2) superficial infection, in 1 case (%4.1) urinary infection, in 1 case (%4.1) stage 1 femoraljissure in two-stage patients developed. A one-stage cementless bilateral THA is as safe as a two-stage procedure. After operation full weight bearing did not have any adverse effect on stability of prosthesis.
Description
Keywords
Aynı veya ayrı seansta, Bilateral, Total kalça protezi, One or two-stage, Bilateral, Total hip arthroplasty
Citation
Bilgen, Ö. F. (2001). ''Aynı ve ayrı seanslarda uygulanan çimentosuz bilateral TKP sonuçlarının karşılaştırılması''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 27(1-2-3), 15-20.