ANATOMİK ENDOBUTTON YÖNTEMİ İLE TEK BAND ARTROSKOPİK ÖÇB REKONSTRÜKSİYONU UYGULANAN HASTALARIMIZIN ORTA DÖNEM TAKİP SONUÇLARI

Yıl 2014, Cilt: 3 Sayı: 3, 155 - 160, 31.12.2014

Burak Günaydın , Ali Turgut Hasan Öztürk Seydi Ahmet Eren Mehmet Korkmaz Tayfun Bacaksız Önder Kalenderer

Öz

AMAÇ: Çalışmamızda, ön çapraz bağ yırtığı sonrasında anatomik Endobutton (Smith & Nephew, Andover, MA) yöntemi ile tek band rekonstrüksiyon uygulanan hastaların orta dönem takip sonuçları incelendi.

YÖNTEMLER: Kliniğimizde Ocak 2008–Aralık 2012 yılları arasında 85 hastaya anatomik Endobutton yöntemi ile tek band artroskopik ÖÇB rekonstrüksiyonu uygulanmıştır ve yeterli takibi olan 36 hasta retrospektif olarak incelenerek çalışmaya dahil edilmiştir. Hastaların 32'si (%89) erkek, dördü (%11) kadın idi. 23'ünün (%64) sağ dizine, 13'ünün(%36) sol dizine rekonstrüksiyon ameliyatı uygulandı. Olgu serimizde ortalama yaş 26.7 idi (dağılım: 17–37). Hastalarımız ameliyat öncesinde ve en az bir yıl takip sonrasında yapılan kontrollerinde; Lysholm Skorlaması sonuçları, IKDC skorlaması, IKDC üç zamanlı aktivite skalası, Modifiye Cincinnati Skorlaması, uyluk çevresi ve klinik muayene ile değerlendirilmişlerdir. Son kontrollerde tek bacakla uzun atlama testi yapılmıştır.

BULGULAR: Olgu serimizde ortalama takip süresi 28.1 ay (12–39) olarak saptandı. Hastaların ameliyat öncesi 57.1 (39-88) olan Lysholm skoru ortalamasının son kontrollerde 93.8 (dağılım 82–100) olduğu saptandı. Ameliyat öncesi 18.9 (11-24) olan Modifiye Cincinnati skoru ortalaması son kontrollerde 28.5 (dağılım 23–30 ) saptandı. Son kontrollerinde uygulanan IKDC skorlamasında hastalarının %97’sinin skoru A veya B olarak değerlendirildi. Hastaların aktivite durumları IKDC aktivite skalasına göre değerlendirildi. Ameliyat öncesi seviye IV grubunda 18 hasta (%50) yer alırken, son kontroller sırasında hiçbir hastanın bu grupta yer almadığı tespit edildi. Ameliyat sonrası hiçbir hastamızın klinik muayenesinde 10 mm üzerinde deplasman tespit edilmedi. Hastalarımızın ameliyat öncesi uyluk atrofisi ortalaması 23 mm (dağılım 5 \ 60 mm) iken ameliyat sonrası ortalama atrofi değeri 9 mm (dağılım –5 \ 40 mm) saptandı. Tek bacakla uzun atlama testinde hastaların 32'sinde (%89) %85'in üzerinde değerlere ulaşıldı.

SONUÇ: Ön çapraz bağ rekonstrüksiyonunda anatomik tek band Endobutton yöntemi ile yapılan cerrahi tedavinin güvenli ve orta dönem sonuçlarının başarılı olduğu kanısına varmaktayız.

Anahtar Kelimeler

Artroskopi, Ön çapraz bağ

MIDTERM RESULTS OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION BY ENDOBUTTON TECHNIQUE WITH SINGLE BUNDLE

Öz

OBJECTIVE: The purpose of this study is to evaluate clinical and functional midterm results of Endobutton (Smith & Nephew, Andover, MA) technique with single bundle.

METHODS: 36 patients who had been operated between january 2008 and december 2012 were included in this study. 32 of them were male (%89) and four of them were female (%11). 23 of the lesions were on the right knee (%64) and 13 of them were on the left knee (%36). The average age of the patients was 26.7 (17-37). The patients were evaluated by the following criterias preoperatively and at the time of last examination; by physical examination (thigh atrophy, range of motion, grade of anterior instability), Lysholm Knee Scores (LNS),Modified Cincinnati Scores (MCS). At the time of last examination; International Knee Documentation Committee Scores (IKDC), IKDC three season activity scales and single leg jump distances were evaluated. RESULTS: Mean Follow-up time was 28.1 months (12-39), Preoperatively; average LNS was 57.1 (39-88), average MCS was 18.9 (11-24) postoperatively these scores were evaluated averagely as following; 93.8 (82-100), 28.5 (23-30). At the time of last examination % 97 of patients were in groups A and B according to IKDC. Preoperatively there were 18 patients (%50) in level 4 activity group but at the time of last examination there were not any patients in this group. All of the patients anterior instability was under 10 millimeters (mm) at last visit. Average thigh atrophy was 23 mm (5 \ 60) preoperatively and 9 mm (-5 \ 40) at last visit. 32 of patients (%89) had achieved over %85 values after single leg jumping distance testing.

CONCLUSION: Clinical and functional midterm results of Endobutton technique with single bundle are successfully. We think that this method is safe and the results are encouraging.

Anahtar Kelimeler

Artroscopy, Anterior cruciate ligament

Kaynakça

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