Ceļa locītavas endoprotēžu revīzijas operāciju rezultāti, lietojot metafizāro defektu aizvietošanu ar slīvēm.
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Totāla ceļa locītavas endoprotezēšanas operāciju skaits mūsdienās palielinās gan Latvijā, gan pasaulē, proporcionāli tam pieaug arī revīziju operāciju skaits. Revīzijas operācijas salīdzinot ar primāru ceļa locītavas endoprotezēšanu, ķirurgiem sagādā lielākas grūtības. Pamata problēma ir kaula plašie bojājumi, kas veidojas pēc nolietotās protēzes izņemšanas. Tāpēc tiek meklētas un ieviestas jaunas aizvietošanas metodes pie revīzijas operācijām, ar domu pagarīnāt protēzes dzīvotspēju, izturību un komplikāciju mazināšanu.
Šī darba mērķis ir analizēt vidējā laika operācijas rezultātus pēc ceļa locītavas endoprotēžu revīzijas operācijas, lietojot metafizārās slīves. Pētījumā tika pētīti Traumatoloģijas un ortopēdijas slimnīcas pacienti, kuriem laika posmā no 2012.-2020. gadam tika veiktas ceļa locītavas endoprotēžu revīzijas operācijas, lietojot metafizārās slīves. Pētījumam tika izvēlēti pacienti, kam aizvietojot metafizāro defektu tika izmantota viena vai abu komponentu metafizārā slīve.
Pētījuma datu izpētei tika izveidots klīniskais protokols, kurā tika fiksēti pacienta demogrāfiskie dati, revīzijas iemsels, operācijas datums, operētā kājas puse, metafizārās slīves komponente. Pacienti tika uzaicināti un apskatīti Traumatoloģijas un ortopēdijas slīmnīcā, lai izvērtētu operētā ceļa locītavas stāvokli, dati tika izvērtēti pēc Knee Society Score (KSS). Tika veikta pacientu pēcoperācijas rentgenogrammu interpretācija, izmantojot KSRES sistēma (The Knee Society Roentgenographic Evaluation and Scoring System).
Kopā tika apskatīti 27 pacienti. Pacientu vidējais vecums bija 71,41, kopš operācijas bija pagājuši vidēji 6 gadi. Pēc KSS skalas ceļa locītavas novērtējums pieauga no 33,15 punktiem līdz 79,15, bet ceļa funkcionālais stāvoklis pieauga no 40,74 līdz 71,48. Vilkiksona tests (Wilcoxon Signed Ranks Test) uzrādīja statistisku nozīmīgumu, salīdzinot pirmsoperācijas KSS un pēcoperācijas KSS (p<0,001). Rentgenoloģiskie dati uzrādīja labu metafizāro slīvju ieaugšanu defekta dobumā.
Var secināt, ka ceļa locītavas endoprotēžu revīzijas operācijas ar metafizārām slīvēm pie metafizāra kaulu bojājuma uzrāda labus klīniskos un rentgenoloģiskos datus.
Nowadays, the number of total knee arthroplasty operations is increasing both in Latvia and in the world, as well as the number of revision operations. Revision surgeries are more difficult for surgeons than primary knee replacement surgery. The main problem is the extensive damage to the bone that occurs after removing a worn prosthesis. Therefore, new replacement methods are being sought and introduced in revision surgery, with the idea of prolonging the viability, durability and reducing complications of the prosthesis. The aim of this work is to analyze the results of average time surgery after knee replacement surgery using metaphyseal sleeves, evaluating clinical and radiological data. The study evaluated patients at the Hospital of Traumatology and Orthopedics who, in the period from 2012 to 2020, have had Knee replacement surgery using metaphyseal sleeves. Patients were selected for the study if during metaphyseal replacement surgery a metaphyseal sleeves of one or both components were used. A clinical protocol was developed to examine the data of the study, in which the patient's demographic data, the reason for the revision surgery, the date of the operation, the operated leg, and the metaphyseal sleeves component were recorded. Patients were invited and examined at the Trauma and Orthopedic Hospital to assess the condition of the operated knee joint, and the data were evaluated using the Knee Society Score (KSS). Postoperative radiographs of patients were interpreted using The Knee Society Roentgenographic Evaluation and Scoring System. A total of 27 patients were examined. The mean age of the patients was 71.41, with an average of 6 years since surgery. According to the KSS scale, the evaluation of the knee joint increased from 33.15 points to 79.15, but the functional condition of the knee increased from 40.74 to 71.48. The Wilcoxon Signed Ranks Test showed statistic significance when comparing preoperative KSS and postoperative KSS (p <0.001). Radiological data showed good ingrowth of metaphyseal sleeves in the defect cavity. It can be concluded that, in comparison with the data obtained in the literature, knee joint endoprosthesis revision surgeries using metaphysical sleeves for metaphysical bone damage show good clinical and radiological data.
Nowadays, the number of total knee arthroplasty operations is increasing both in Latvia and in the world, as well as the number of revision operations. Revision surgeries are more difficult for surgeons than primary knee replacement surgery. The main problem is the extensive damage to the bone that occurs after removing a worn prosthesis. Therefore, new replacement methods are being sought and introduced in revision surgery, with the idea of prolonging the viability, durability and reducing complications of the prosthesis. The aim of this work is to analyze the results of average time surgery after knee replacement surgery using metaphyseal sleeves, evaluating clinical and radiological data. The study evaluated patients at the Hospital of Traumatology and Orthopedics who, in the period from 2012 to 2020, have had Knee replacement surgery using metaphyseal sleeves. Patients were selected for the study if during metaphyseal replacement surgery a metaphyseal sleeves of one or both components were used. A clinical protocol was developed to examine the data of the study, in which the patient's demographic data, the reason for the revision surgery, the date of the operation, the operated leg, and the metaphyseal sleeves component were recorded. Patients were invited and examined at the Trauma and Orthopedic Hospital to assess the condition of the operated knee joint, and the data were evaluated using the Knee Society Score (KSS). Postoperative radiographs of patients were interpreted using The Knee Society Roentgenographic Evaluation and Scoring System. A total of 27 patients were examined. The mean age of the patients was 71.41, with an average of 6 years since surgery. According to the KSS scale, the evaluation of the knee joint increased from 33.15 points to 79.15, but the functional condition of the knee increased from 40.74 to 71.48. The Wilcoxon Signed Ranks Test showed statistic significance when comparing preoperative KSS and postoperative KSS (p <0.001). Radiological data showed good ingrowth of metaphyseal sleeves in the defect cavity. It can be concluded that, in comparison with the data obtained in the literature, knee joint endoprosthesis revision surgeries using metaphysical sleeves for metaphysical bone damage show good clinical and radiological data.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
ceļa locītavas endoprotēžu revīzijas operācijas, metafizārā slīve, metafizārs kaulu defekts, revision knee replacement surgery, metaphyseal sleeves, metaphyseal bone defect