Total Diz Artroplastisi Sonrası Erken Dönemde Postoperatif Ödemin Propriyosepsiyon Üzerine Etkisi


Özet Görüntüleme: 121 / PDF İndirme: 64

Yazarlar

  • Mahmut BEŞLİ Ankara Yıldırım Beyazıt Üniversitesi Sağlık Bilimleri Enstitüsü Fizyoterapi ve Rehabilitasyon ABD
  • Ayşe Neriman NARİN

DOI:

https://doi.org/10.5281/zenodo.10721831

Anahtar Kelimeler:

Postoperatif Ödem, Propriyosepsiyon, Total diz artroplastisi, Ağrı, Fizyoterapi ve Rehabilitasyon

Özet

Giriş: Ağrı, eklem sertliği, ödem, eklem hareket açıklığı kısıtlılığı, kas zayıflığı ve propriyosepsiyon kayıpları gibi semptomların görüldüğü osteoartrit, en sık karşılaşılan dejeneratif eklem hastalığıdır. Ödem ve propriyosepsiyon kayıpları TDA nedeniyle daha da artar. Bu çalışmada yaşam kalitesi ile bağımsızlık düzeyini olumsuz etkileyen propriyosepsiyon kayıpları üzerinde, TDA sonrası postoperative ödemin etkisini araştırmayı amaçladık.

Materyal ve Metot: TDA sonrası 1. ayında olan 35 gönüllü katılımcıya, postoperative ödem ve propriyosepsiyon değerlendirmeleri yapıldı. Çevre ölçümleri Frustom formülü kullanılarak hacimsel forma dönüştürüldü. Propriyosepsiyon ölçümü için 40° ve 60° diz fleksiyonu açılarında Angle-Reproduction testi kullanıldı.

Bulgular: Çalışmaya dahil edilen katılımcılarda postoperatif ödem ve propriyosepsiyon kaybı istatistiksel olarak tespit edildi (p<0.05). Patella üstü hacim ve toplam hacmin 40° diz fleksiyonu propriyosepsiyonunu etkilediği tespit edildi (p<0.05), fakat 60° diz fleksiyonu üzerinde ödemin etkisi tespit edilmedi (p>0.05).

Tartışma: Propriyosepsiyon kemik periostu, deri ve kas liflerinden gelen uyarılarla işlenir. Cerrahi teknikler ve postoperatif ödem nedeniyle özellikle Quadriceps Femoris kasındaki motor nöronların spinal inhibitor mekanizmaları tetiklenerek kaslarda otojenik inhibisyon ortaya çıkar ve kas aktivitesi azalır. Patella üstünde yer alan periartiküler yapıların postoperatif ödemden etkilenmesiyle 40° diz fleksiyonu propriyosepsiyonu etkilenirken, patella altı yapılarda postoperatif ödem propriyosepsiyonu etkilemeyebilir.

Sonuç ve Öneriler: Bu çalışma, TDA sonrası erken dönemde postoperatif ödemin propriyosepsiyonu etkilediğini ortaya koymaktadır. TDA sonrası planlanan erken fizyoterapi programlarında postoperatif ödemin azaltılması birincil öneme sahiptir.

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Yayınlanmış

2024-02-28

Nasıl Atıf Yapılır

BEŞLİ, M., & NARİN, A. N. (2024). Total Diz Artroplastisi Sonrası Erken Dönemde Postoperatif Ödemin Propriyosepsiyon Üzerine Etkisi. GEVHER NESİBE TIP VE SAĞLIK BİLİMLERİ DERGİSİ, 9(1), 143–152. https://doi.org/10.5281/zenodo.10721831

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