TOTAL DİZ ARTROPLASTİSİNDE, HAREKETLİ VE SABİT TASARIMLI TİBİAL İNSERT KULLANIMININ KLİNİK SONUÇLARA ETKİSİ: RETROSPEKTİF ÇALIŞMA

Year 2024, Volume: 87 Issue: 1, 81 - 86, 29.01.2024

Mehmet Fevzi Çakmak , Levent Horoz

https://doi.org/10.26650/IUITFD.1347402

Abstract

Amaç: Total diz replasmanı prosedürü ileri evre diz osteoartriti vakalarında yaygın olarak kullanılmakta ve tatmin edici sonuçlara ulaşılmaktadır. Sabit tasarımlı dizaynlar birçok yazar tarafından altın standart olarak bildirilmişken, hareketli tasarımlı dizaynların daha uyumlu eklemleşmesi ve buna bağlı eklem yüzeyinde düşük temas stresinin olduğu düşünülmektedir. Bu çalışmanın amacı, mobil ve sabit insert total diz protezi tasarımlarını karşılaştırmak ve klinik sonuçları bildirmektir.
Gereç ve Yöntem: Çalışmaya hareketli ve sabit tasarımlı özdeş implantlar uygulanan ve en az üç yıl takip edilen 212 hasta dahil edildi. Hastaların eklem hareket açıklığı, ağrı skorları, implant sağ kalımı ve fonksiyonel skorları kaydedildi.
Bulgular: Hareketli ve sabit tasarımlı dizaynlar karşılaştırıldığında sırasıyla gruplardaki olgu sayısı 106 ve 116 iken, ortalama yaş 63,1±8,0 ve 63,9±7,0 idi ve anlamlı fark izlenmedi. Birinci yıl ve son takipte Diz cemiyeti skoru (KSS), eklem hareket açıklığı and vizuel analog skala (VAS) açısından anlamlı fark izlenmedi. İki grubun ortalama takip süreleri sırasıyla 62,4 (38-92) ve 66,8 (40- 88) ay idi. Komplikasyon oranları her grup için benzerdi.
Sonuç: Hareketli ve sabit tasarımlı total diz protezlerinin klinik ve fonksiyonel sonuçları mükemmeldir. Hareketli insert tasarımlı total diz protezinin birçok teorik avantajına rağmen, bu çalışma iki grup arasında erken fonksiyonel sonuçlarda çok az anlamlı fark gösterdi. Çalışma sonucunda, hareketli ve sabit tasarımlı total diz protezlerinin klinik olarak birbirinden üstün olmadığı görüşüne varılmıştır.

Keywords

Total diz protezi, hareketli insert, sabit insert, protez aşınması, protez sağkalımı

EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY

Abstract

Objective: Total knee replacement (TKR) procedures are widely used in cases of advanced knee osteoarthritis, and satisfactory results are achieved. Although the fixed-bearing (FB) design has been reported as the gold standard by many authors, the mobile-bearing (MB) design has been argued to have more harmonious articulation and to cause less contact stress on the joint surface. This study aims to compare mobile-bearing and fixed-bearing total knee replacement designs and presenting the clinical outcomes.
Material and Methods: The study includes 212 patients who’ve undergone MB and FB implants with identical design, had at least three years of follow-ups, and had their range of motion, pain scores, implant survival, and functional scores recorded.
Result: When comparing the MB and FB designs, the MB group has 106 cases with an average age of 63.1±8.0, and the FB group has 116 cases with an average age of 63.9±7.0 years; no significant difference was observed between the groups. Also, no significant difference was observed regarding Knee Society scores (KSS), range of motion (ROM), or visual analogue scales (VAS) between the first year and last follow-up. The mean follow-up times of the two groups are 62.4 months (range=38-92) for the MB group and 66.8 months (range=40-88) for the FB group. Each group also had similar complication rates.
Conclusion: The clinical and functional results for both the MB and FB-design total knee prostheses are excellent. Despite the many theoretical advantages of MB total knee replacement, this study shows little significant difference in the early functional outcomes between MB and FB prostheses. The study concludes neither MB- or FB-design TKR to have clinically superiority.

Keywords

Total knee replacement, mobile bearing, fixed bearing, prosthesis loosening, prosthesis survival

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