UPOTREBA IMPLANTA SA DIZAJNOM ROTIRAJUĆE ŠARKE U REVIZIONOJ TOTALNOJ ARTROPLASTICI KOLENA
Sažetak
Uvod: Broj totalnih artroplastika kolena pokazuje rastući trend u svim svetskim ortopedskim centrima. Iako totalna artroplastika kolena pokazuje odličnu stopu dugoročnog preživljavanja, ne iznenađuje činjenica da će, imajući u vidu produženje životnog veka i sve stariju populaciju sa većim brojem komorbiditeta, i učestalost revizionih artroplastika kolena takođe rasti. Česte indikacije za reviziju totalne artroplastike kolena predstavljaju aseptično razlabavljenje i periprotetski prelomi.
Prikaz slučajeva: Pacijentkinja starosti 60 godina javila se u našu ustanovu zbog tegoba u vidu bola i nestabilnosti desnog kolena. Primarna artroplastika urađena je u drugoj ustanovi pre 9 godina. Radiografska evaluacija pokazala je aseptično razlabavljenje komponenti totalne endoproteze kolena, sa utonućem tibijalne komponente u varusnoj poziciji. Pacijentkinja starosti 73 godine primljena je u našu ustanovu zbog povrede levog kolena nastale usled pada na ravnoj podlozi, 5 dana pre prijema. Primarna artroplastika urađena je pre 14 godina u našoj ustanovi. Trauma RTG snimci povređenog kolena ukazali su na Lewis tip IIB periprotetski prelom tibijalnog platoa. Kod obe pacijentkinje urađena je reviziona artroplastika koristeći implantat povećane stabilnosti sa dizajnom rotacione šarke. Postoperativni oporavak protekao je uspešno u oba slučaja. Radiografije kolena pokazale su adekvatnu poziciju implanta nakon perioda praćenja od 2 godine.
Zaključak: Upotreba implanta povećane stabilnosti sa dizajnom rotacione šarke u revizionoj artroplastici kolena pokazuje ohrabrujuće rezultate i ishode, naročito u slučajevima gde postoji značajan gubitak koštane mase, kao i ligamentarna nestabilnost.
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