Total Diz Protezi Komplikasyonları
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DOI:
https://doi.org/10.5281/zenodo.10722045Anahtar Kelimeler:
Diz Protezi, Total Diz Replasmanı, KomplikasyonlarÖzet
Amaç: Bu çalışmanın amacı Total Diz Artroplastisi (TDA) ile ilişkili komplikasyonların sıklığını ve tiplerini belirlemek, TDA uygulanan hastaların klinik ve radyolojik sonuçlarını değerlendirmektir.
Gereç ve Yöntem: Çalışmaya hastanemizde TDA uygulanan 319 hastanın 376 dizi dahil edildi. Hastaların tıbbi özgeçmişleri ameliyat öncesi muayene bulguları, direkt grafileri, laboratuvar verileri, ameliyat verileri, postoperatif takip süresi, görülen komplikasyonlar ve ameliyat sonrasına ait antero-posterior ve lateral radyografileri değerlendirildi. Grafilerde ameliyat öncesi ve sonrası varus-valgus dizilim açıları, ameliyat sonrası alfa, beta, gama, sigma ve omega açıları ölçüldü. Hastalar, diz artroplastisinin klinik ve radyolojik değerlendirmesi için Knee Society Score (KSS) kullanılarak değerlendirildi.
Bulgular: Hastaların yaş ortalaması 67.7 idi (35-87) ve 252’si kadındı (%79). Ortalama takip süresi 32.6 aydı (4-92). KSS diz skoru ve fonksiyon skorlarının her ikisinde de ameliyattan sonra anlamlı artış gözlendi. (p<0.0001) Ameliyat öncesi hastaların ortalama eklem hareket açıklığı 108.3° (70-135) iken, ameliyat sonrası ortalama 113.2° (70-140) olarak bulundu. (p=0,014) Erken enfeksiyon en sık görülen komplikasyondu (%3.4). Diğer komplikasyonlar kronik enfeksiyon (%1.2), yara yeri komplikasyonu (1,5), peroneal sinir yaralanması (%0.6), safen sinir infrapatellar dalında nöroma (%0,3), derin ven trombozu (%1.5), ekstansör mekanizma komplikasyonları (%0.6), hareket kısıtlılığı (0,6), aseptik gevşeme (%0.6) ve suprakondiler femur kırığıdır. (%0,3) Radyografik ölçümlerde çoğu hastada uygun dizilimin sağlandığı görüldü.
Sonuç: Total diz artroplastisi, ağrı ve fonksiyon bozukluğunun giderilmesinde etkili bir tedavi metodudur. (p<0.0001) Çalışmanın sonucunda en sık karşılaşılan komplikasyon erken dönem enfeksiyondur. Erken enfeksiyon vakalarında çoğu vakada üreme olmadı. ‘İkinci sıklıkta görülen komplikasyonun ise derin ven trombozu (DVT) olduğunu tespit ettik. Bu komplikasyonları azaltmak için enfeksiyon önleme stratejileri ve perioperatif bakımın iyileştirilmesine yönelik araştırmalar yapılması gerekmektedir.
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