SOL TOTAL DİZ ARTROPLASTİSİ SAĞ EL DOMİNANT CERRAH İÇİN NEDEN DAHA ZORDUR? TOTAL DİZ ARTROPLASTİSİNDE TARAF ANALİZİ

Objective: We hypothesize that right-handed surgeons can achieve equally successful results in both right and left sides of patients, although they are exposed to more occupational damage when performing knee arthroplasty on the left side. Material and Methods: A total of 246 (113 right and 133 left) total knee prosthesis operations performed by two right-handed orthopaedic surgeons in our institution were included. Patients were divided into right and left knee arthroplasty groups for comparison. The demographic data of the patients, the knee range of motion (ROM), hip-knee-ankle angle (HKAA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and Knee Society Score (KSS) values were evaluated for all groups. Moreover, electromyographic measurements of specific muscle groups, which were used while performing the right and left total knee arthroplasty procedures, were taken for the two surgeons to compare the differences in efficacy of surgeries performed on different sides. Results: There was no statistically significant difference between the two groups when the postoperative bleeding volumes and flexion, extension levels, and pain and function scores at 3 months and 1 year were compared There was no significant difference between groups in term of postoperative ROM, HKAA, LDFA, MPTA, and KSS values. It was observed that the right latissimus dorsi muscles of the surgeons exhibited about five times more activation, the left latissimus dorsi muscles exhibited three times more activation, and the left gluteus medius muscles exhibited two times more activation during left knee surgery than right knee surgery. Conclusion: Right-handed surgeons can provide equally good results when operating left knees as right ones, although they exert more effort when performing left-sided arthroplasty. However, we conclude that left knee surgeries cause more occupational damage for surgeons.