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Çeşitli Total Diz Protezi Uygulamalarının (Bilateral Simultane, Ardışık Bilateral ya da Tek Yanlı) Erken Postoperatif Komplikasyonlara Etkisi

The Influence of the Total Knee Prosthesis Applications (Bilateral, Simultaneous, Consecutive Bilateral or Single-Sided) on the Early Postoperative Complications

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2016
DOI: 
10.5505/abantmedj.2016.21033

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
INTRODUCTION: In the surgical treatment of the advancedstage knee arthrosis, two-compartment knee prosthesis surgery is applied successfully in which femoro-tibial joint is usually replaced. Application can be performed by using various methods in bilateral cases in the same session or in different sessions. In this study, we compared simultaneous bilateral total knee arthroplasty (TKA) with bilateral TKA with session and with unilateral TKA in terms of early postoperative complications. METHODS: 285 series of the 185 patient having late-period gonarthrosis in which simultaneous bilateral TKA (n=85), bilateral TKA with sessions (n=30) and unilateral TKA (n=85) were applied between April 2004 and January 2005 were retrospectively assessed. The records of these 185 patients were studied within the mean period of 27.1±9.85 months in terms of demographic sampling, preoperative concurrent diagnosis and perioperative complications. The type of surgery, age, gender, ASA (American Anesthesiology Association) Scores and tourniquet time were compared in terms of perioperative complications. RESULTS: In patients in which simultaneous bilateral TKA was applied and in those with ASA2 among this patient group the perioperative complication ratio was significantly higher compared to those with ASA1 (p<0.027 and p<0.171 respectively). The TKA type and the incidence of complication were demonstrating significant variation depending on the surgery type (p=0.034). The incidence of complication was statistically higher in bilateral simultaneous surgeries compared to unilateral group (p=0.012). DISCUSSION AND CONCLUSION: Bilateral TKA has significantly higher perioperative complication risk compared to applications with sessions and to the unilateral applications. However, decision for simultaneous bilateral TKA should be made in case of suitable indication, if this is confirmed by the patient and in the direction of the preference of the patient.
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Abstract (Original Language): 
GİRİŞ ve AMAÇ: İleri evre diz artrozunun cerrahi tedavisinde genellikle femoro-tibial eklemin değiştirildiği iki kompartmanlı diz protezi ameliyatı başarıyla uygulanmaktadır. Uygulama, bilateral olgularda değişik yöntemler kullanılarak; aynı seansta ya da farklı zamanlarda şeklindedir. Bu çalışmada simultane bilateral total diz artroplastisi (TDA), seanslı bilateral TDA ve unilateral TDA'ni erken postoperatif komplikasyonlar yönünden karşılaştırdık. YÖNTEM ve GEREÇLER: Nisan 2004 ve Ocak 2009 tarihleri arasında, simultane bilateral (n=85), seanslı bilateral (n=30) ve unilateral (n=85) TDA uygulanan toplam 185 hastanın son dönem gonartroza sahip 285 dizi retrospektif olarak değerlendirilmiştir. Bu 185 hastanın kayıtları ortalama 27,1±9,85 aylık takip periodunda, demografik örnekleme, preoperatif eştanılar ve perioperatif komplikasyonlar açısından incelendi. Cerrahinin tipi, yaş, cinsiyet, ASA (Amerikan Anesteziyoloji Birliği) skorları ve turnike zamanı perioperatif komplikasyonlar açısından karşılaştırıldı. BULGULAR: Simultane bilateral TDA uygulanan hastalarda ve bu hasta grubunda ASA 2 olanlarda ASA 1 olanlara göre perioperatif komplikasyon oranı belirgin olarak daha yüksekti (sırasıyla, p<0,027 ve p<0,171). TDA uygulama tipi ile 70 yaş altında olan hasta grubu içerisinde komplikasyon görülme sıklığı operasyon türüne bağlı olarak anlamlı değişim göstermekteydi (p=0,034). Bilateral simultane operasyonlarda komplikasyon görülme sıklığı unilateral grubuna göre istatistiksel olarak daha yüksek idi (p=0,012). TARTIŞMA ve SONUÇ: Seanslı ve unilateral uygulamalara göre simultane bilateral TDA belirgin olarak daha yüksek perioperatif komplikasyon riskine sahiptir. Ancak, simultane bilateral TDA uygulamasına, uygun endikasyon durumunda, hastanın onayı ve tercihi doğrultusunda karar verilmelidir.
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  • Turkish

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