The effect of wound closure position in total knee arthroplasty on postoperative pain and function

Year 2019, Volume: 10 Issue: 4, 510 - 514, 31.12.2019

Çağdaş Pamuk

https://doi.org/10.18663/tjcl.526983

Abstract

Aim

After total knee arthroplasty (TKA), there are publications showing the
importance of soft tissue balance in pain control and functional results. In
existing publications there is no consensus on which position should be the
insicion closed. In this study, we aimed to investigate the effect of the
incision closure in the full flexion position or in full extension position
during TKA and the effect on postoperative pain and function.

 

Materials
and Methods

A total of 61 patients who were scheduled for TKA
operation due to severe gonarthrosis were included in the study. Thirty
patients who were sutured while the knee was in the maximum flexion position in
the incision of the TKA sequence were identified as Group1, and 31 patients
sutured in the full extension position were determined as Group 2. Demographic
characteristics (age, weight, body mass index (BMI)) of the patients. preop,
postoperative 1st week, postoperative 2nd week motion range and pain scores
were compared between the groups.

Results

There was no significant difference between the groups
in terms of VAS values ​​in the preoperative period. In the 1st week
postoperative range of motion and pain scores were significantly lower in Group
1 (p <0.001). No significant difference was observed between the groups at
the 6th week.

Conclusion

There is no consensus on which position the incision
will be closed in TKA. However, in the literature and as seen in the present
study, we think that the functional results of the repairs performed in the
flexion position are better in the early period.

Keywords

Knee Replacement Arthroplasty, Range of Motion, Articular, Rehabilitation

Total diz artroplastisinde insizyon kapatılırken diz pozisyonunun, postoperatif ağrı ve fonksiyona etkisi

Abstract

Amaç

Literatürde total diz artroplastisi
(TDA) sırasında inzisyonun hangi pozisyonda kapatılması gerektiği konusunda
fikir birliği yoktur. İnsizyon bölgesindeki gerginlik, hematom oluşması aynı
zamanda ekstensör mekanizmanın uyumsuz kapatılmasının erken dönemde kötü
fonksiyonel sonuçlar doğurabileceği bildirilmiştir. Bu çalışmada TDA sırasında
dizin tam fleksiyon pozisyonunda insizyonun kapatılması ile tam ekstansiyon
pozisyonda kapatılmasının, postoperatif ağrı ve fonksiyona olan etkisini
araştırmayı amaçladık.

Gereç
ve Yöntemler

İleri derece gonartroz nedeniyle TDA
operasyonu planlanan 61 hasta çalışmaya dahil edildi. TDA sırasından insizyonu
diz maksimum fleksiyon pozisyonundayken sütüre edilen 30 hasta Grup 1 olarak,
tam ekstansiyon pozisyonunda sütüre edilen 31 hasta Grup 2 olarak belirlendi.
Gruplar arasında (1) hastaların demografik özellikleri (yaş, kilo, beden kitle
indeksi (BKİ)) (2) preop, postop 1. hafta, postop 2. hafta eklem hareket
açıklığı değerleri ve ağrı skorları karşılaştırıldı.

Bulgular

Gruplar arasında ağrı değerleri
açısından preoperatif dönemde anlamlı bir fark yoktur. Postop 1. haftada eklem
hareket açıklığı ve ağrı skorları Grup 1’de anlamlı oranda düşüktür
(p<0,001). 6. hafta incelendiğinde gruplar arasında anlamlı bir fark
görülmemektedir.

Sonuç

TDA da insizyonun hangi pozisyonda
kapatılacağı konusunda fikir birliği yoktur. Ancak literatürde ve bu çalışmada
görüldüğü gibi fleksiyon pozisyonunda gerçekleştirilen onarımların fonksiyonel
sonuçlarının erken dönemde daha iyi olduğu düşüncesindeyiz.

Keywords

Diz replasman artroplastisi, Hareket açıklığı, Eklem, Rehabilitasyon

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