Öz
Amaç
Retrospektif olan bu çalışmamızda izole ön çapraz bağ (ÖÇB) rekonstrüksiyonu ve ÖÇB rekonstrüksiyonu ile birlikte menisküs tamiri veya menisküs rezeksiyonunun klinik sonuçlarını karşılaştırmak amaçlanmıştır.
Yöntem
İzole ÖÇB rekonstrüksiyonu grubunda 4 kadın ve 25 erkek, ÖÇB rekonstrüksiyonu ile birlikte menisküs tamiri yapılan grubunda 6 kadın ve 21 erkek, ÖÇB rekonstrüksiyon ile birlikte menisektomi yapılan grubunda 4’ü kadın 21’i erkek hasta dahil edildi. Tüm hastalarımız transtibial, dörtlü hamstring otogreft ile tek demet ve tek tünel endobutton yöntemiyle opere edildi. Menisküs yırtıkları ise tamamen içerde yöntemle onarıldı. Tüm grupların demografik özellikler, preop ve postop birinci yılda fonksiyonel skorlamaları (Lysholm, Tegner, Cincinnati ve Uluslararası Diz Dokümantasyon Komitesi), preop ve postop 1. yıl ön çekmece testi ve lachman testleri, yaralanma-operasyon arasında geçen süreleri, menisküsün yırtık tipi ve posterior tibial eğim açıları karşılaştırıldı.
Bulgular
Menisküs rezeksiyonu yapılan grubun %56’sı 12. aydan sonra ameliyat olup hastaların menisküs yırtıkların onarıma uygun olmayan bir menisküs yırtığı paternine karşılaşma olasılığı artmış olduğu görüldü. Her üç grubun post-op fonksiyonel sonuçları preop sonuçlarına göre anlamlı düzeyde yüksek ve her üç grubun erken dönemde klinik sonuçları tatmin edici seviyede saptadık. Tegner aktivite düzeyi skoru ÖÇB rekonstrüksiyon ile beraber menisküs onarımı olan grupta menisküs rezeksiyonu yapılan grubuna göre anlamlı düzeyde yüksek saptadık.
Sonuç
Çalışmamızda menisküs tamiri yapılan hastalar menisketomi yapılanlara göre daha yüksek tegner aktivite skorlarına sahiptiler. Menisküs tamiri olan hastalarda yük verme ve hareket kısıtlaması verilmişti. Bu sonuçlara göre yük verme ve hareket kısıtlamasının klinik sonuçlarına etkisi olmadığını gösterdi. Hastaların en kısa sürede ve güvenli bir şekilde spora veya eski aktivitelerine dönmeye çabalamalarını tavsiye edilmelidir.
Anahtar Kelimeler:
Ön çapraz bağ rekonstrüksiyon, menisketomi, menisküs tamiri
Kaynaklar
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