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Beden Kitle İndeksi 35 Üstü Olan Hastalarda Unikondiler Diz Protezi Kısa Dönem Sonuçlarımız

Yıl 2021, Cilt: 13 Sayı: 2, 181 - 185, 07.06.2021

Şahin Çepni Ahmet Fırat

https://doi.org/10.18521/ktd.809804

Öz

Amaç:Bu çalışmada medial kompartman artrozlu obez hastalarda unikondiler diz protezinin kısa dönem sonuçlarınının ve komplikasyonlarının değerlendirilmesi amaçlandı.

Gereç ve Yöntem: Medial kompartman artrozu tanısıyla BKİ >35 olan 41 hastaya(36 kadın 5 erkek;ort.yaş 56)unikondiler diz protezi uygulandı.Tüm hastalara Oxford faz 3 çimentosuz protez kullanıldı.Hastalar ameliyat öncesi ve sonrası eklem hareket açıklığı,VAS,OKS,KSS part 1 ve KSS part 2 skorlamasına göre değerlendirildi.

Bulgular: Hastaların preop fleksiyonları ortalama 115 (90; 135) derece postop fleksiyonları ortalama 120 (90; 130) derece, preop ekstansiyonları ortalama 0 (-10; 0) derece postop fleksiyonları ortalama 0 (-15; 0) derece olup anlamlı fark saptanmamıştır.Hastaların preop KSS Part 1 58 (36; 82) postop 85 (57; 96)(p <0.001), preop KSS Part 2 50 (35; 80) postop 90 (51; 100) (p <0.001), preop Oxford skoru 16 (9; 30) postop 38 (20; 44) (p <0.001) olup istatistiksel olarak anlamlı bulunmuştur.1 hastada (%2.4) periprostatik eklem enfeksiyonu ,2 hastada (%4.9) insert çıkığı olmak üzere toplamda 3 hastada(%7,3) komplikasyon saptandı.

Sonuç:Bulgularamız,obez hastalarda unikondiler diz protezi uygulamasanın medial gonartroz tedavisinde kısa dönemde etkili ve başarılı olduğunu göstermektedir.Uzun dönem sonuçlar için daha uzun takip süreli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Unikondiler diz protezi Medial gonartroz Obezite

Destekleyen Kurum

YOK

Proje Numarası

72300690-799

Kaynakça

  • 1-Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60:91–7
  • 2-Dawson J, Linsell L, Zondervan K, et al. Epidemiology of hip and knee pain and its impact on overall health status in older adults. Rheumatology. 2004; 43:497–504.
  • 3- Scott CEH, Wade FA, MacDonald D, Nutton RW. Ten-year survival and patient-reported outcomes of a medial unicompartmental knee arthroplasty incorporating an all-polyethylene tibial component. Arch Orthop Trauma Surg 2018;38:719–729
  • 4- Tang H, Zhao L, Yan H, Jin D, Su X . Mid-term effectiveness of Oxford unicompartmental knee system phase III for medial unicompartmental knee osteoarthritis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2012;26:17–20
  • 5- Kandil A, Werner BC, Gwathmey WF, Browne JA. Obesity, morbid obesity and their related medical comorbidities are associated with increased complications and revision rates after unicompartmental knee arthroplasty. J Arthroplasty. 2015;30:456–60.
  • 6- Jeschke E, Gehrke T, Günster C, Hassenpflug J, Malzahn J, Niethard FU, Schrader P, Zacher J, Halder A. Five-year survival of 20949 unicondylar knee replacements and patient risk factors for failure: an analysis of German insurance data. J Bone Joint Surg Am. 2016;98:1691–8.
  • 7-Plate JF, Augart MA, Seyler TM, Bracey DN, Hoggard a AM, Jinnah RH, Poehling GG. Obesity has no effect on outcomes following unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25:645 –51
  • 8- Cavaignac E, Lafontan V, Reina N, Pailhe R, Wargny M, Laffosse JM, Chiron P. Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J. 2013; 95-B:1064 –8
  • 9-Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16(1):87-101.
  • 10-Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, CarrAJ, Dawson J . The use of the Oxford hip and knee scores.J Bone Joint Surg Br 2007;89-B:1010–1014
  • 11. Insall JN, Dorr LD, Scott RD, Scott WN . Rationale of the knee society clinical rating system. Clin Orthop Relat Res 1989; 248:13–14
  • 12- Plate JF, Augart MA, Seyler TM, et al. Obesity has no effect on outcomes fol¬lowing unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2017;25:645–651
  • 13-. Woo YL, Chen YQ, Lai MC, et al. Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty? J Orthop Surg 2017;25:2309499016684297.
  • 14-. Cavaignac E, Lafontan V, Reina N, et al. Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J 2013;95-B:1064–1068.
  • 15 Berend KR, Lombardi AV Jr, Mallory TH, Adams JB, Groseth KL.Early failure of minimally invasive unicompartmental kneearthroplasty is associated with obesity. Clin Orthop Relat Res 2005;440(440):60–66
  • 16- Bonutti PM,GoddardMS, Zywiel MG, Khanuja HS, Johnson AJ,MontMA.Outcomes of unicompartmental knee arthroplasty stratifiedby body mass index. J Arthroplasty 2011;26(08):1149–1153
  • 17- Murray DW, Pandit H, Weston-Simons JS, et al. Does body mass index affect the outcome of unicompartmental knee replacement? Knee 2013;20(06):461–465
  • 18-Pandit H, Jenkins C, Gill HS, et al. Unnecessary contraindications for mobile-bearing unicompartmental knee replacement. J BoneJoint Surg Br 2011;93(05):622–628
  • 19- Deshmukh RV, Scott RD. Unicompartmental knee arthroplasty: long-term results. Clin Orthop Relat Res. 2001;392:272–8.
  • 20-Kort NP, Van Raay JJ, Van Horn JJ. The Oxford phase III unicompartmentalknee replacement in patients less than 60 years of age. Knee Surg SportsTraumatol Arthrosc. 2007;15:356–60.
  • 21-Cavaignac E, Lafontan V, Reina N, Pailhe R, Wargny M, Laffosse JM, Chiron P. Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J. 2013; 95-B:1064–8.
  • 22- Kuipers BM, Kollen BJ, Bots PC, Burger BJ, Van Raay JJ, Tulp NJ, Verheyen CC. Factors associated with reduced early survival in the Oxford phase III medial unicompartmental knee replacement. Knee. 2010;17:48–52.
  • 23- Plate JF, Augart MA, Seyler TM, Bracey DN, Hoggard a AM, Jinnah RH, Poehling GG. Obesity has no effect on outcomes following unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc.2017;25:645–51.
  • 24-Seth A,Dobransky J,Albishi W,Dervin GF. Mid-Term Evaluation of the Unicompartmental Knee Arthroplasty in Patients with BMI of 40 or Greater. J Knee Surg.2019;25:645–51
  • 25-Liddle AD, Judge A, Pandit H, Murray DW. Adverse outcomes after total and unicompartmental knee replacement in 101,330 matched patients: a study of data from the National Joint Registry for England and Wales. Lancet 2014;384:1437-45.
  • 26-Simpson DJ, Price AJ, Gulati A, Murray DW, Gill HS. Elevated proximal tibial strains following unicompartmental knee replacement-a possible cause of pain. Med Eng Phys 2009;31:752e7
  • 27-American Academy of Orthopaedic Surgeons Workgroup on Obesity. Position Statement 1184: The Impact of Obesity on Bone and Joint Health. American Academy of Orthopaedic Surgeons adopted ;March 2015.

The Short-Term Results of Unıcondylar Knee Prosthesis in Patients with Body Mass İndex Over 35

Yıl 2021, Cilt: 13 Sayı: 2, 181 - 185, 07.06.2021

Şahin Çepni Ahmet Fırat

https://doi.org/10.18521/ktd.809804

Öz

Objective: To evaluate the short-term results and complications of unicondylar knee prosthesis in obese patients with medial compartment arthrosis.

Method: Unicondylar knee prosthesis was applied to 41 patients (36 females, 5 males; average age 56 years) with BMI >35 for the treatment of medial compartment arthrosis. Cementless Oxford phase 3 prosthesis was applied to all patients. Joint range of motion before and after surgery, VAS, OKS, and the KSS part 1 and part 2 scores of the patients were examined.

Results: Flexion was measured as mean 115° (range, 90°- 135°) preoperatively, and 120° (range, 90° - 130°) postoperatively, extension as mean 0° (range, -10°- 0°) preoperatively and 0° (range,-15° - 0°) postoperatively, with no significant difference determined. The KSS Part 1 score was mean 58 (range, 36-82) preoperatively, and 85 (range, 57 - 96) postoperatively (p <0.001). The KSS part 2 score was 50 (range, 35- 80) preoperatively, and 90 (range, 51 -100) postoperatively (p <0.001). The Oxford score was mean 16 (range, 9 - 30) preoperatively, and 38 (range, 20 - 44) postoperatively (p <0.001). The differences between these scores were determined to be statistically significant. Complications developed in a total of 3 patients as periprosthetic joint infection in 1 patient (2.4%), and insert dislocation in 2 patients (4.9%).

Conclusion: The study findings demonstrated that the application of unicondylar knee prosthesis is effective and successful in obese patients treated for medial gonarthrosis. There is a need for further long-term studies to confirm these results.

Anahtar Kelimeler

unicondylar knee prosthesis medial gonarthrosis obesity

Proje Numarası

72300690-799

Kaynakça

  • 1-Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60:91–7
  • 2-Dawson J, Linsell L, Zondervan K, et al. Epidemiology of hip and knee pain and its impact on overall health status in older adults. Rheumatology. 2004; 43:497–504.
  • 3- Scott CEH, Wade FA, MacDonald D, Nutton RW. Ten-year survival and patient-reported outcomes of a medial unicompartmental knee arthroplasty incorporating an all-polyethylene tibial component. Arch Orthop Trauma Surg 2018;38:719–729
  • 4- Tang H, Zhao L, Yan H, Jin D, Su X . Mid-term effectiveness of Oxford unicompartmental knee system phase III for medial unicompartmental knee osteoarthritis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2012;26:17–20
  • 5- Kandil A, Werner BC, Gwathmey WF, Browne JA. Obesity, morbid obesity and their related medical comorbidities are associated with increased complications and revision rates after unicompartmental knee arthroplasty. J Arthroplasty. 2015;30:456–60.
  • 6- Jeschke E, Gehrke T, Günster C, Hassenpflug J, Malzahn J, Niethard FU, Schrader P, Zacher J, Halder A. Five-year survival of 20949 unicondylar knee replacements and patient risk factors for failure: an analysis of German insurance data. J Bone Joint Surg Am. 2016;98:1691–8.
  • 7-Plate JF, Augart MA, Seyler TM, Bracey DN, Hoggard a AM, Jinnah RH, Poehling GG. Obesity has no effect on outcomes following unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25:645 –51
  • 8- Cavaignac E, Lafontan V, Reina N, Pailhe R, Wargny M, Laffosse JM, Chiron P. Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J. 2013; 95-B:1064 –8
  • 9-Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16(1):87-101.
  • 10-Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, CarrAJ, Dawson J . The use of the Oxford hip and knee scores.J Bone Joint Surg Br 2007;89-B:1010–1014
  • 11. Insall JN, Dorr LD, Scott RD, Scott WN . Rationale of the knee society clinical rating system. Clin Orthop Relat Res 1989; 248:13–14
  • 12- Plate JF, Augart MA, Seyler TM, et al. Obesity has no effect on outcomes fol¬lowing unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2017;25:645–651
  • 13-. Woo YL, Chen YQ, Lai MC, et al. Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty? J Orthop Surg 2017;25:2309499016684297.
  • 14-. Cavaignac E, Lafontan V, Reina N, et al. Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J 2013;95-B:1064–1068.
  • 15 Berend KR, Lombardi AV Jr, Mallory TH, Adams JB, Groseth KL.Early failure of minimally invasive unicompartmental kneearthroplasty is associated with obesity. Clin Orthop Relat Res 2005;440(440):60–66
  • 16- Bonutti PM,GoddardMS, Zywiel MG, Khanuja HS, Johnson AJ,MontMA.Outcomes of unicompartmental knee arthroplasty stratifiedby body mass index. J Arthroplasty 2011;26(08):1149–1153
  • 17- Murray DW, Pandit H, Weston-Simons JS, et al. Does body mass index affect the outcome of unicompartmental knee replacement? Knee 2013;20(06):461–465
  • 18-Pandit H, Jenkins C, Gill HS, et al. Unnecessary contraindications for mobile-bearing unicompartmental knee replacement. J BoneJoint Surg Br 2011;93(05):622–628
  • 19- Deshmukh RV, Scott RD. Unicompartmental knee arthroplasty: long-term results. Clin Orthop Relat Res. 2001;392:272–8.
  • 20-Kort NP, Van Raay JJ, Van Horn JJ. The Oxford phase III unicompartmentalknee replacement in patients less than 60 years of age. Knee Surg SportsTraumatol Arthrosc. 2007;15:356–60.
  • 21-Cavaignac E, Lafontan V, Reina N, Pailhe R, Wargny M, Laffosse JM, Chiron P. Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J. 2013; 95-B:1064–8.
  • 22- Kuipers BM, Kollen BJ, Bots PC, Burger BJ, Van Raay JJ, Tulp NJ, Verheyen CC. Factors associated with reduced early survival in the Oxford phase III medial unicompartmental knee replacement. Knee. 2010;17:48–52.
  • 23- Plate JF, Augart MA, Seyler TM, Bracey DN, Hoggard a AM, Jinnah RH, Poehling GG. Obesity has no effect on outcomes following unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc.2017;25:645–51.
  • 24-Seth A,Dobransky J,Albishi W,Dervin GF. Mid-Term Evaluation of the Unicompartmental Knee Arthroplasty in Patients with BMI of 40 or Greater. J Knee Surg.2019;25:645–51
  • 25-Liddle AD, Judge A, Pandit H, Murray DW. Adverse outcomes after total and unicompartmental knee replacement in 101,330 matched patients: a study of data from the National Joint Registry for England and Wales. Lancet 2014;384:1437-45.
  • 26-Simpson DJ, Price AJ, Gulati A, Murray DW, Gill HS. Elevated proximal tibial strains following unicompartmental knee replacement-a possible cause of pain. Med Eng Phys 2009;31:752e7
  • 27-American Academy of Orthopaedic Surgeons Workgroup on Obesity. Position Statement 1184: The Impact of Obesity on Bone and Joint Health. American Academy of Orthopaedic Surgeons adopted ;March 2015.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Şahin Çepni 0000-0001-6850-7439

Ahmet Fırat 0000-0001-9182-7270

Proje Numarası 72300690-799
Yayımlanma Tarihi 7 Haziran 2021
Kabul Tarihi 27 Mart 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 13 Sayı: 2

Kaynak Göster

APA Çepni, Ş., & Fırat, A. (2021). The Short-Term Results of Unıcondylar Knee Prosthesis in Patients with Body Mass İndex Over 35. Konuralp Medical Journal, 13(2), 181-185. https://doi.org/10.18521/ktd.809804
AMA Çepni Ş, Fırat A. The Short-Term Results of Unıcondylar Knee Prosthesis in Patients with Body Mass İndex Over 35. Konuralp Medical Journal. Haziran 2021;13(2):181-185. doi:10.18521/ktd.809804
Chicago Çepni, Şahin, ve Ahmet Fırat. “The Short-Term Results of Unıcondylar Knee Prosthesis in Patients With Body Mass İndex Over 35”. Konuralp Medical Journal 13, sy. 2 (Haziran 2021): 181-85. https://doi.org/10.18521/ktd.809804.
EndNote Çepni Ş, Fırat A (01 Haziran 2021) The Short-Term Results of Unıcondylar Knee Prosthesis in Patients with Body Mass İndex Over 35. Konuralp Medical Journal 13 2 181–185.
IEEE Ş. Çepni ve A. Fırat, “The Short-Term Results of Unıcondylar Knee Prosthesis in Patients with Body Mass İndex Over 35”, Konuralp Medical Journal, c. 13, sy. 2, ss. 181–185, 2021, doi: 10.18521/ktd.809804.
ISNAD Çepni, Şahin - Fırat, Ahmet. “The Short-Term Results of Unıcondylar Knee Prosthesis in Patients With Body Mass İndex Over 35”. Konuralp Medical Journal 13/2 (Haziran 2021), 181-185. https://doi.org/10.18521/ktd.809804.
JAMA Çepni Ş, Fırat A. The Short-Term Results of Unıcondylar Knee Prosthesis in Patients with Body Mass İndex Over 35. Konuralp Medical Journal. 2021;13:181–185.
MLA Çepni, Şahin ve Ahmet Fırat. “The Short-Term Results of Unıcondylar Knee Prosthesis in Patients With Body Mass İndex Over 35”. Konuralp Medical Journal, c. 13, sy. 2, 2021, ss. 181-5, doi:10.18521/ktd.809804.
Vancouver Çepni Ş, Fırat A. The Short-Term Results of Unıcondylar Knee Prosthesis in Patients with Body Mass İndex Over 35. Konuralp Medical Journal. 2021;13(2):181-5.
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