Steroide bağlı femur başı avasküler nekrozunda drilizasyon, plateletten zengin plazma, kemik iliği, plateletten zengin plazma + kemik iliği tedavilerinin karşılaştırılması
Küçük Resim Yok
Dosyalar
Tarih
2014
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Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/embargoedAccess
Özet
Bu çalışmanın amacı; steroide bağlı gelişen femur başı avasküler nekrozunda dekompresyon, dekompresyonla birlikte konsantre kemik iliği uygulaması, dekompresyonla birlikte plateletten zengin plazma uygulaması ve dekompresyonla birlikte konsantre kemik iliği + plateletten zengin plazma uygulaması tedavilerinin karşılaştırılmasıdır. Bu amaçla deneysel olarak femur başında avasküler nekroz oluşumunu sağlamak üzere 40 adet Yeni Zellanda cinsi tavşanın her birine tek doz 40 mg/kg intramuskuler metilprednisolonasetat uygulandı. Avasküler nekroz oluşumu için 4 hafta beklendikten sonra hayvanlar 4 gruba ayrılarak planlanan tedaviler uygulandı. Cerrahi işlem sonrası 6 hafta beklendikten sonra hayvanlar sakrifiye edildi ve çıkarılan femur başları histopatolojik olarak değerlendirildi. Histopatolojik olarak elde edilen sonuçların istatistiksel analizi yapıldı. Nekroz yönünden %10,5556'lık oran ile plateletten zengin plazma grubu en az nekroz görülen grup olarak değerlendirildi. Yeni kemik oluşumu yönünden %27,7778'likoran ile plateletten zengin plazma grubu en fazla yeni kemik oluşumunun görüldüğü grup olarak değerlendirildi. İltihabi reaksiyon yönünden %15'lik oran ile plateletten zengin plazma grubu iltihabi reaksiyon cevabının en fazla olduğu grup olarak değerlendirildi. Fibrozis yönünden gruplar arasından istatistiksel olarak anlamlı farklılık bulunamadı. Remodelizasyon yönünden gruplar arasında istatistiksel olarak anlamlı fark bulunamadı. Kıkırdak dejenerasyonu yönünden plateletten zengin plazma + konsantre kemik iliği uygulanan grup ile sadece drilleme yapılan grup arasında istatistiksel olarak anlamlı fark tesbit edildi ve bu doğrultuda en fazla kıkırdak dejenerasyonunun sadece drilleme yapılan grupta olduğu görüldü. Sonuç olarak dekompresyonla birlikte plateletten zengin plazma uygulanan grupta nekrotik doku miktarının az olması, oluşan yeni kemik miktarının daha fazla olması ve en fazla iltihabi reaksiyon cevabının alınması nedeniyle diğer gruplara üstün olduğu görülmüştür.
The purpose of this study is to compare decompression, decompression with concentrated bone marrow application, decompression with platelet-rich plasma application and decompression with concentrated bone marrow + platelet-rich plasma application treatments in steroid-induced femoral head avascular necrosis. In order to induce the femoral head avascular necrosis as experimentally; single dose of 40 mg / kg metilprednisolon asetat was administered intramuscularly to each one of 40 New Zealand rabbits. After waiting 4 weeks for formation of avascular necrosis; required treatments were performed by subjects were divided into 4 groups. The subjects were sacrified 6 weeks after surgical procedure and femoral heads were evaluated histopathologically. Statistical analysis was performed to results obtained by histopathology. In terms of necrosis, necrosis was seen at least in platelet-rich plasma group with a rate of 10.5556%. In terms of new bone formation; platelet-rich plasma group with a rate of 27.7778% was evaluated as group the greatest new bone formation was seen. In terms of inflammatory reaction; platelet-rich plasma group with a rate of 15% was evaluated as group the greatest inflammatory reaction responce was seen. In terms of fibrosis and remodelling; there were no statistically significant differences between groups. In terms of cartilage degeneration; statistically significant differences were detected between platelet-rich plasma + concentrated bone marrow group and decompression group; the greatest cartilage degeneration was seen in decompression group. In conclusion; decompression with platelet-rich plasma applied group has been found superior to other groups due to caused less necrotic tissue, greater new bone formation and greater inflammatory reaction responce.
The purpose of this study is to compare decompression, decompression with concentrated bone marrow application, decompression with platelet-rich plasma application and decompression with concentrated bone marrow + platelet-rich plasma application treatments in steroid-induced femoral head avascular necrosis. In order to induce the femoral head avascular necrosis as experimentally; single dose of 40 mg / kg metilprednisolon asetat was administered intramuscularly to each one of 40 New Zealand rabbits. After waiting 4 weeks for formation of avascular necrosis; required treatments were performed by subjects were divided into 4 groups. The subjects were sacrified 6 weeks after surgical procedure and femoral heads were evaluated histopathologically. Statistical analysis was performed to results obtained by histopathology. In terms of necrosis, necrosis was seen at least in platelet-rich plasma group with a rate of 10.5556%. In terms of new bone formation; platelet-rich plasma group with a rate of 27.7778% was evaluated as group the greatest new bone formation was seen. In terms of inflammatory reaction; platelet-rich plasma group with a rate of 15% was evaluated as group the greatest inflammatory reaction responce was seen. In terms of fibrosis and remodelling; there were no statistically significant differences between groups. In terms of cartilage degeneration; statistically significant differences were detected between platelet-rich plasma + concentrated bone marrow group and decompression group; the greatest cartilage degeneration was seen in decompression group. In conclusion; decompression with platelet-rich plasma applied group has been found superior to other groups due to caused less necrotic tissue, greater new bone formation and greater inflammatory reaction responce.
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TOPGÜL, H. (2014). Steroide bağlı femur başı avasküler nekrozunda drilizasyon, plateletten zengin plazma, kemik iliği, plateletten zengin plazma + kemik iliği tedavilerinin karşılaştırılması, İnönü Üniversitesi / Tıp Fakültesi / Ortopedi ve Travmatoloji Ana Bilim Dalı.
