FEMUR BAŞI OSTEONEKROZU: VAKUM DRENLİ VE VAKUM DRENSİZ KOR DEKOMPRESYON SONUÇLARI

Raif Özden, Ömer Serkan Yıldız, İbrahim Gökhan Duman, Vedat Uruç
1.611 534

Öz


Amaç: Bu çalışmanın amacı sadece kor
dekompresyon yapılan hastalar ile kor
dekompresyondan sonra, açılan tünele
vakumlu dren konulan hastaların
sonuçlarını karşılaştırmaktır.
Yöntem ve Gereç: 25 hastanın 39 kalçası
iki eşit gruba bölündü. Birinci gruba
(n=19) sadece kor dekompresyon, ikinci
gruba (n=20) ise kor dekompresyondan
sonra açılan tünele vakumlu dren konuldu.
İki gup arasındaki fark klinik olarak
karşılaştırıldı. Klinik olarak Harris kalça
skorlaması kullanıldı. İki grubu
karşılaştırmak için Mann-Whitney U testi
uygulandı.

Bulgular: Altıncı ayda, Harris kalça
skorlaması ile hastalar karşılaştırıldığında
iki grup arasında anlamlı fark bulunamadı.
Fakat gruplar kendi içinde
karşılaştırıldığında kor dekompresyonun
sonuçları önemli ölçüde iyileştirdiği
gözlenmiştir.
Sonuç: Erken evre osteonekrozun
tedavisinde kor dekompresyon Harris kalça
skorunu önemli ölçüde iyileştirmiştir fakat
kor dekompresyon ile açılan tünele
vakumlu dren konulmasının, sonuç üzerine
herhangi bir etkisi olmadığı gözlenmiştir.
Anahtar kelimeler; Femur başı
osteonekrozu; Kor dekompresyon; Kalça


Anahtar kelimeler


Anahtar osteonekrozu; Kor dekompresyon; Kalça

Tam metin:

PDF


Referanslar


Mont MA, Hungerford DS. Non-traumatic avascular necrosis of the femoral head. J Bone

Joint Surg Am 1995;77(3):459-74.

Lavernia CJ, Sierra RJ, Grieco FR. Osteonecrosis of the femoral head. J Am Acad Orthop

Surg 1999;7(4):250–61.

Lai KA, Shen WJ, Yang CY, Shao CJ, Hsu JT, Lin RM. The use of alendronate to

prevent early collapse of the femoral head in patients with nontraumatic osteonecrosis. A

randomized clinical study. J Bone Joint Surg Am2005; 87(10):2155–9.

Agarwala S, Jain D, Joshi VR, Sule A. Efficacy of alendronate, a bisphosphonate, in the

treatment of AVN of the hip. A prospective open-label study. Rheumatology

;44(3):352–9.

Reis ND, Schwartz O, Militianu D, Ramon Y, Levin D, Norman D, et al. Hyperbaric

oxygen therapy as a treatment for stage-I avascular necrosis of the femoral head. J Bone

Joint Surg Br 2003;85(3):371–5.

Aaron RK, Steinberg ME. Electrical stimulation of osteonecrosis of the femoral head.

Semin Arthroplasty 1991;2(3):214–21.

Wang CJ, Wang FS, Huang CC, Yang KD, Weng LH, Huang HY. Treatment for

osteonecrosis of the femoral head: comparison of extracorporeal shock waves with core

decompression and bone-grafting. J Bone Joint Surg Am2005;87(11):2380–7.

Linovitz RJ, Pathria M, Bernhardt M, Green D, Law MD, McGuire RA, et al. Combined

magnetic fields accelerate and increase spine fusion: a double blind, randomized, placebo

controlled study. Spine 2002;27(13):1383–9.

Radke S, Kirschner S, Seipel V, Rader C, Eulert J. Magnetic resonance imaging criteria

of successful core decompression in avascular necrosis of the hip. Skeletal Radiol

;33(9):519–23.

Mont MA, Ragland PS, Etienne G. Core decompression of the femoral head for

osteonecrosis using percutaneous multiple small-diameter drilling. Clin Orthop Relat Res

;(429):131–8.

Koo KH, Kim R, Ko GH, et al. Preventing collapse in early osteonecrosis of the femoral

head. A randomised clinical trial of core decompression. J Bone Joint Surg Br

;77(6):870-4

Steinberg ME, Brighton CT, Corces A, Hayken GD, Steinberg DR, Strafford B, Tooze

SE, Fallon M. Osteonecrosis of thefemoral head. Results of core decompression and

grafting with and without electrical stimulation. Clin Orthop Relat Res.1989;(249):199–

Gangji V, Hauzeur JP. Treatment of osteonecrosis of the femoral head with implantation

of autologous bone-marrow cells. Surgical technique. J Bone Joint Surg Am

;87(1):106-112.

Hernigou P, Beaujean F. Treatment of osteonecrosis with autologous bone marrow

grafting. Clin Orthop Relat Res. 2002;(405):14–23.

Steinberg ME, Larcom PG, Strafford B, Hosick WB, Corces A, Bands RE, Hartman KE.

Core decompression with bone grafting for osteonecrosis of the femoral head. Clin

Orthop Relat Res 2001;(386):71–78.

Yoo MC, Chung DW, Hahn CS. Free vascularized fibula grafting for the treatment of

osteonecrosis of the femoral head. ClinOrthop Relat Res. 1992;(277):128–138.

Kim SY, Kim YG, Kim PT, Ihn JC, Cho BC, Koo KH. Vascularized compared with

nonvascularized fibular grafts for large osteonecrotic lesions of the femoral head. J Bone

Joint Surg Am. 2005;87(9):2012–2018.

Plakseychuk AY, Kim SY, Park BC, Varitimidis SE, Rubash HE, Sotereanos DG.

Vascularized compared with nonvascularized fibular grafting for the treatment of

osteonecrosis of the femoral head. J Bone Joint Surg Am 2003;85(4):589–596.

Steinberg ME, Steinberg DR Classification systems for osteonecrosis: an overview.

Orthop Clin North Am 2004;35(3):273–283

Camp JF, Colwell CW Jr. Core decompression of the femoral head for osteonecrosis. J

Bone Joint Surg Am 1986;68(9):1313-1319.

Hopson CN, Siverhus SW. Ischemic necrosis of the femoral head. Treatment by core

decompression. J Bone Joint Surg Am 1988;70(7):1048–1051.

Steinberg ME, Larcom PG, Strafford B, Hosick WB, Corces A, Bands RE et al. Core

decompression with bonegrafting for osteonecrosis of the femoral head. Clin Orthop

Relat Res 2001;(386):71–78.

Petrigliano FA, Lieberman JR. Osteonecrosis of the hip: novel approaches to evaluation

and treatment. Clin Orthop RelatRes 2007;(465):53–62.

Ficat RP. Idiopathic bone necrosis of the femoral head: early diagnosis and treatment. J

Bone Joint Surg Br 1985;67(1):3-9.

Mont MA, Carbone J J, Fairbank AC: Core decompression versus non-operative

management for osteonecrosis of the hip. Clin Orthop 1996;(324):169-78.

Zhao FC, Li ZR, Zhang NF, Wang BL, Sun W, Cheng LM et al. Lesion size changes in

osteonecrosis of the femoral head: a long-term prospective study using MRI. Int Orthop

;34(6):799-804.




Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.