Crowe Evre 3 ve Evre 4 Gelişimsel Kalça Displazili Hastalarda Çimentosuz Total Kalça Artroplastisi Uygulaması Sonrası Fonksiyonel Sonuçlar Elde Etmek Mümkün Mü?

Yıl 2021, Cilt: 6 Sayı: 3, 1 - 5, 30.09.2021

Mehmet Maden , Mahmut Tunçez , Süleyman Sofulu , Cemal Kazimoglu

Öz

Amaç: Gelişimsel kalça displazisi toplumda genç erişkin yaş grubunda total kalça artroplastisi uygulanmasının en önemli nedenlerinden birisidir. Bu hastalarda artroplasti uygulaması teknik anlamda ortopedik cerrahlar açısından son derece zorlu ve karmaşıktır. Çalışmanın amacı, Crowe evre 3 ve 4 gelişimsel kalça displazili hastalarda total kalça artroplastisinin orta dönem fonksiyonel sonuçlarının değerlendirilmesidir.
Gereç ve Yöntem: 2017-2020 yılları arasında gelişimsel kalça displazisi nedeniyle total kalça artroplastisi uygulanan 10 hasta çalışmamıza dahil edildi. Ortalama yaş 52 olarak saptandı. Üç hasta Crowe evre 3, yedi hasta ise Crowe evre 4’tü. Hastalar retrospektif olarak incelendi. Değerlendirmede Harris Kalça Skorları, fizik muayene ve radyografik analiz parametreleri kullanıldı.
Bulgular: Ortalama takip süresi 18 aydı ve hastalarda hesaplanan minimum Harris Kalça Skoru 88, maksimum 95 puan olmak üzere ortalama Harris Kalça Skoru 93 (88-95) olarak bulundu. Osteotomi yapılan hiçbir hastada kaynamama izlenmedi. Postoperatif dönemde ortalama her iki bacak arası uzunluk farkı 0 cm saptandı. Hiçbir hastada siyatik sinir hasarı ve enfeksiyon görülmedi.
Sonuç: Evre 3-4 gelişimsel kalça displazili olgularda uygulanan total kalça artroplastisi ile iyi fonksiyonel sonuçlar elde etmek mümkündür. Bu hastalarda total kalça artroplastisi sonrası normale yakın bir bacak restorasyonu ve hastalar için fizyolojik bir kalça oluşturulması sağlanabilir.

Anahtar Kelimeler

Gelişimsel kalça displazisi, Total kalça artroplastisi, Kısaltma osteotomisi

Is It Possible to Obtain Functional Results after Cementless Total Hip Arthroplasty in Patients with Crowe Stage 3 and Stage 4 Developmental Hip Dysplasia?

Öz

Objective: Developmental hip dysplasia is one of the most important causes of the application of total hip arthroplasty in young adults. In these patients ,arthroplasty is technically very difficult and complex for orthopedic surgeons. The purpose of this study is to evaluate the mid-term functional results of total hip arthroplasty in patients with Crowe stage 3 and 4 developmental hip dysplasia.
Materials and Method: 10 patients who underwent total hip arthroplasty due to developmental hip dysplasia were included in our study between 2017 and 2020. The average age was 52. Three patients were Crowe stage 3, and seven were Crowe stage 4. Patients were analyzed retrospectively. The evaluation was performed through Harris Hip Scores, physical examination, and radiographic analysis.
Results: The average follow-up period was 18 months and the Harris Hip Scores varied from a minimum 88 to a maximum 95 points with an average score of 93 (88-95). Nonunion was not observed in any patient who underwent osteotomy. In the postoperative period, the average difference in length between both legs was 0 cm. No patients had sciatic nerve damage and infection.
Conclusion: It is possible to achieve good functional results with total hip arthroplasty in cases with stage 3-4 developmental hip dysplasia. In these patients, a near-normal leg restoration and a physiological hip can be obtained after total hip arthroplasty.

Anahtar Kelimeler

Developmental hip dysplasia, Total hip arthroplasty, Shortening osteotomy

Kaynakça

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