Rotator Manşet Yırtıklarında Artroskopik Yardımlı Mini Açık ve Artroskopik Tamir Yöntemlerinin Klinik ve Radyolojik Sonuçlarının Karşılaştırılması

Year 2018, Volume: 8 Issue: 4, 788 - 797, 30.12.2018

Levent Bayam , Eren Kıran Mehmet Erdem Alauddin Kochai , Mehmet Türker

https://doi.org/10.31832/smj.434096

Cited By: 1

Abstract

SONUÇ: Rotator manşet yırtığının tedavinde hem
artroskopi yardimlı
mini açık ve hem de artroskopi, klinik
ve radyolojik olarak başarılı sonuçlar
vermektedir. Yöntemlerin arasinda ağrı, fonksiyon kapasitesi,
hareket açıklığı, kuvvet skorları ve memnuniyet arasından anlamlı bir fark bulunmadi. Sonuçlar
her iki yöntemin, ilgili ortopedistler için uygun olabilecegini göstermektedir. 

Group 1 ve 2 nin kiyaslamasinda UCLA p=0,94, Constant p=
0,356 bulundu.  Iki grubun fizik muayene, radyolojik ve
subjektif verileri arasinda
anlamlı bir farklılık bulunmadi.

Cerrahi sonrası fizik muayene, radyolojik
ve subjektif verilerinde her iki grupta ameliyat öncesine göre
belirgin olarak iyileşme gösterdiği görüldü (p<0,0001).

Radyolojik
Thomazeau atrofi ve yağlı dejenerasyon sınıflamasında, 11 grade 1, 25 grade 2, 4 grade 3 idi. Tendon bütünlüğü
sağlam olarak değerlendirilen hastalarda yağlı dejenerasyon ve atrofide artma izlenmedi, yırtık olan 6
hastanın
3’ünde seviye artış gözlendi.

Grup 2’ de, ortalama yaşı 53,1 idi. UCLA skorlaması ameliyat öncesi ortalama
11,12
sonrası 31,16. Constant Murley
skorlaması ameliyat öncesi
ortalama 31, sonrası 87,48 idi.

BULGULAR: Grup 1’de, ortalama yaş 57,4 idi. 
UCLA skorlaması ameliyat
öncesi ortalama 10,93, sonrası 32,46 idi. Constant Murley skorlaması ameliyat öncesi ortalama 31,6 sonrası 88,13 idi. 

GEREÇ VE YÖNTEMLER: 2014-2016 yılları arasında 40
hasta 2 grup halinde retrospektif
olarak incelendi. 15 atroskopi
yardımlı mini açık (grup 1), 25
artroskopik yöntemle (grup 2) tedavi edildi. Gruplar, yaş, cinsiyet, cerrahi öncesi ve sonrası muayene ve radyolojik bulgular, Constant Murley ve
UCLA skorlamaları açısından değerlendirildi.

AMAÇ: Rotator
manşet yırtıklarının tamirinde
uygulanan artroskopi yardımlı mini açık ve artroskopik yöntemlerinin
klinik ve radyolojik olarak karşılaştırılması amaclanmistir.

Keywords

Rotator Manşon Rüptürü;, Artroskopik cerrahi;, Omuz;, Tamir

Clinical and Radiology Comparison of Arthroscopy-Aided Mini Open and Arthroscopic Repair Methods for Rotator Cuff Tears

Abstract

OBJECTIVE: We aimed clinical and radiologic comparison of
arthroscopy assisted mini open and arthroscopic repair methods for rotator cuff
tears.

MATERIALS AND METHODS: Forty
patients between 2014 and 2016 were retrospectively reviewed; divided into 2 groups;
15 patients (group 1- mini open) and 25 (group 2 - arthroscopic). Age, gender,
surgical intervention, pre and post surgical examination findings, Constant
Murley, UCLA scores, radiological findings were evaluated.

RESULTS: Mean
age was 57.4 for group 1 and 53.1 for group 2. Mean UCLA score improved to
32.46 postoperatively from 10.93 for group 1 and to 1.12 from 31.16
postoperatvely for group 2. Mean Constant Murley score improved to 88.13
postoperatively from 31,6
for group 1 and to 87.48 postoperatively from 31 for group 2.

Radiological classification by Thomazeau showed 11
patients grade 1, 25 grade 2 and 4 grade 3. There was no increase in fatty
degeneration in patients with intact tendon, but increase in 3 with tears.

Postoperative physical examination, radiological and
subjective evaluation showed significant improvement in both groups (p <0,0001).

In comparison of groups, p was 0.356 for UCLA and 0.94 for Constant Murley. 
There was no significant difference for physical examination,
radiological and subjective data between groups.

CONCLUSION: Both arthroscopy assisted mini-open and arthroscopic
methods were clinically and radiologically successful for rotator cuff repair
There was no significant difference in pain, functional capacity, range of
motion, strength scores and satisfaction rates between groups. These results
suggest that both approaches may be appropriate for orthopedists with necessary
experience.

Keywords

Rotator cuff tears;, Arthroscopic Surgery;, Shoulder;, Repair

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