Femur boyun kırıklı hastaların tedavisinde uygulanan çimentolu ve çimentosuz hemiartroplasti sonuçlarının karşılaştırılması
Küçük Resim Yok
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı, femur boyun kırığı nedeniyle çimentolu ve çimentosuz bipolar hemiartroplasti ile tedavi edilmiş hastalarda, bu iki protez tipinin fonksiyonel iyileşme ve yaşam kalitesi üzerine etkileri ile, perioperatif komplikasyonları, revizyon ameliyat oranları ile ölüm oranlarını geriye dönük olarak karşılaştırmaktır. Yöntem:Bu çalışmada,2010-2017 yılları arasında kliniğimize femur boyun kırığı tanısıyla yatırılan ve parsiyelartroplasti yapılan hastalar kliniğimiz arşivinden retrospektif olarak belirlendi. Femur boyun kırığı nedeni ile parsiyel artroplasti yapılan 55 yaş ve üstü hastalar çalışmaya dahil edildi. 55 yaş altı, diğer kalçasında dakırık olan veya femur boyun kırığı öncesinde her iki alt ekstremitesi ile ilgili herhangi bir problem nedeniyle cerrahi tedavi görmüş hastalar ve telefon ile ulaşılamayan olgular değerlendirme dışı bırakıldı.106 çimentolu, 68 çimentosuz parsiyelartroplasti uygulanan kriterlere uygun toplam 174 tane hasta çalışmaya dahil edildi. Bulgular:Çalışmamızda çimentolu protez yapılan grupta yaş ortalaması 80 iken çimentosuz grupta 71 idi. Erkeklerin sayısı çimentolu grupta 40(%37,7) iken, kadınların sayısı ise 66(%62,3), çimentosuz protez uygulanan grupta erkeklerin sayısı 35(%51,5)bayanların sayısı ise 33(%48,5) idi.Hastaların 162'si (%93,1) merdivenden yada ev içinde basit düşme nedeni ile oluşurken, 7 (%4) hastada zorlama nedeni ile patolojik kırık,5 (%2,9) hastada trafik kazası nedeniyle yüksek enerjili yaralanma neticesinde kırık gelişmiştir.Genel olarakçimentosuz artroplasti uygulanan hastalarda, kalça Harris skorları, Barthel indeksleri ve Womac skorları çimentolu gruba göre daha iyiydi.Hastaları 75 yaş altı ve 75 yaş üstü olarak sınıflandırıp fonksiyonel skorlamalarına(barthel indeksi,womac,harris) baktık.75 yaş altı hastalarda çimentosuz grupta skorlamalar daha iyi iken 75 yaş üstü hastalarda çimentolu ve çimentosuz iki grup arasında fonksiyonel skorlamalar açısından anlamlı bir fark yoktu.Toplamda 28 hastada perioperatif komplikasyon görülmüştür. Bunların 5'i dislokasyon,2'si enfeksiyon, 3'ü pulmoner emboli,18'i de intraoperatif kırık idi. Sonuç:75 yaş altı hastalarda gerek fonksiyonel gerekse morbidite ve mortalite açısından çimentosuz hemiartroplastinin sonuçları çimentolu hemiartroplastiye göre daha iyi olduğu için bu hasta grubunda çimentosuz hemiartroplastinin;75 yaş üstü hastalarda ise erken mobilizasyon gerekliliği,kemik kalitesinin kötü olması ve fonksiyonel sonuçları açısından iki grup arasında farklılık olmaması nedeniyle çimentolu hemiartroplasti uygulamasının iyi bir seçenek olduğu kanısındayız.
Objectives: The aim of this study was to retrospectively compare the perioperative complications, revision surgery rates and mortality rates in patients treated with cemented and uncemented bipolar hemiarthroplasty due to femoral neck fracture with their effects on functional recovery and quality of life. Methods:In this study, we retrospectively evaluated the patients who were hospitalized with the diagnosis of femoral neck fracture between 2010-2017 and who underwent partial arthroplasty.Patients aged 55 years or older who underwent partial arthroplasty for femoral neck fractures were included in the study. Patients who were under 55 years old, who had fracture in the contralateral hip or who had undergone surgery due to any problems related to both lower extremities prior to femoral neck fracture and those who could not be reached with the phone were excluded from the evaluation.A total of 174 patients were identified, which were in compliance with the criteria applied to 106 cemented and 68 non-cemented partial arthroplasty.A total of 174 patients who were in compliance with the criteria were identified, cemented partial arthroplasty applied to 106 of those while the other 68 undergone uncemented partial arthroplasty. Findings: In our study, the mean age was 80 in the cemented prosthesis group and 71 in the cementless group. In the cemented groupthe number of males was 40 (37.7%), while the number of females was 66 (62.3%) and the number of males in the non-cemented prosthesis group was 35 (51.5%) while the number of females was 33 (48.5%) in the same group.When cemented and cementless group were viewed from sight of comorbidities; the number of patients with comorbiditis in the cemented group was 69 (65.1%) and the number of patients without comorbid disease was 37 (34.9%). On the other hand, the number of patients with comorbidity in the cementless group was 33 (48.3%) while the number of patients with no additional disease was 35 (51.7%) in the same group.While 162 (93.1%) of the patients were developed fracture by a simple fall in the staircase or in the home, 7 (4%) patients had pathological fractures due to coercion and 5 (2.9%) patients developed fractures due to high-energy injury resulted from traffic accident.Hip Harris scores, Barthel indexes and Womac scores were better in patients who had uncemented arthroplastythan cemented group. A total of 28 patients had perioperative complications. Of these, 5 were dislocation, 2 were infection, 3 were pulmonary embolism and 18 were intraoperative fractures. Conclusion: As the results of cementless hemiarthroplasty are better than cemented hemiarthroplasty in patients under 75 years of age in terms of both functional state, morbidity and mortality, cementless hemiarthroplasty is a good treatment option in this patient group. In patients over 75 years of age, the necessity of early mobilization, poor bone quality and lack of differences between the two groups in terms of functional results,we think that the application of cemented hemiarthroplasty is a better treatment option for patients in this age group.
Objectives: The aim of this study was to retrospectively compare the perioperative complications, revision surgery rates and mortality rates in patients treated with cemented and uncemented bipolar hemiarthroplasty due to femoral neck fracture with their effects on functional recovery and quality of life. Methods:In this study, we retrospectively evaluated the patients who were hospitalized with the diagnosis of femoral neck fracture between 2010-2017 and who underwent partial arthroplasty.Patients aged 55 years or older who underwent partial arthroplasty for femoral neck fractures were included in the study. Patients who were under 55 years old, who had fracture in the contralateral hip or who had undergone surgery due to any problems related to both lower extremities prior to femoral neck fracture and those who could not be reached with the phone were excluded from the evaluation.A total of 174 patients were identified, which were in compliance with the criteria applied to 106 cemented and 68 non-cemented partial arthroplasty.A total of 174 patients who were in compliance with the criteria were identified, cemented partial arthroplasty applied to 106 of those while the other 68 undergone uncemented partial arthroplasty. Findings: In our study, the mean age was 80 in the cemented prosthesis group and 71 in the cementless group. In the cemented groupthe number of males was 40 (37.7%), while the number of females was 66 (62.3%) and the number of males in the non-cemented prosthesis group was 35 (51.5%) while the number of females was 33 (48.5%) in the same group.When cemented and cementless group were viewed from sight of comorbidities; the number of patients with comorbiditis in the cemented group was 69 (65.1%) and the number of patients without comorbid disease was 37 (34.9%). On the other hand, the number of patients with comorbidity in the cementless group was 33 (48.3%) while the number of patients with no additional disease was 35 (51.7%) in the same group.While 162 (93.1%) of the patients were developed fracture by a simple fall in the staircase or in the home, 7 (4%) patients had pathological fractures due to coercion and 5 (2.9%) patients developed fractures due to high-energy injury resulted from traffic accident.Hip Harris scores, Barthel indexes and Womac scores were better in patients who had uncemented arthroplastythan cemented group. A total of 28 patients had perioperative complications. Of these, 5 were dislocation, 2 were infection, 3 were pulmonary embolism and 18 were intraoperative fractures. Conclusion: As the results of cementless hemiarthroplasty are better than cemented hemiarthroplasty in patients under 75 years of age in terms of both functional state, morbidity and mortality, cementless hemiarthroplasty is a good treatment option in this patient group. In patients over 75 years of age, the necessity of early mobilization, poor bone quality and lack of differences between the two groups in terms of functional results,we think that the application of cemented hemiarthroplasty is a better treatment option for patients in this age group.
Açıklama
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology