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Anterior omuz instabilitesinde artroskopikstabilizasyon: Tek anterior portal

Year 2015, Volume: 49 Issue: 1, 6 - 12, 19.03.2015
https://doi.org/10.3944/AOTT.2015.14.0035

Abstract

Amaç: Artroskopik instabilite cerrahisinde tek anterior portal kullanılarak yapılan cerrahi sonuçlarını değerlendirip literatürle karşılaştırması amaçlamıştır.

Çalışma planı: Dahil etme kriterlerine sahip travmatik anterior omuz instabilitesi tanısı olan 72 (60 erkek, 12 kadın; ortalama yaş:23.9) hasta çalışmaya dahil edilmiştir. Bu hastalar 2002 -2011 yılla¬rı arasında tek artroskopik anterior portal kullanılarak tedavi edilmişlerdir. Klinik değerlendirmeler Oxford ve Rowe skalaları, öne doğru olan fleksiyon eklem hareket açıklığı, dış rotasyondaki kısıtlılık kullanılarak yapılmıştır. Tekrar çıkık başarısızlık olarak değerlendirilmiştir.

Bulgular: Ortalama takip süresi 49.3 aydır. Hastaların 38 tanesinde Bankart lezyonu, 34 tanesinde Bankart ile birlikte SLAP lezyonu saptanmıştır. Ortalama 3.7 (2-5) ankor kullanılmıştır. Postoperatif periyotta tekrar çıkık 4 (%5.6) hastada gözlenmiştir. Postoperatif periyotta Rowe skoru 93.4 ve Ox¬ford skoru 42.6 olarak saptanmıştır. Bu çalışmada hastaların kullanılan artroskopik yöntemden fayda gördükleri saptanmıştır.

Çıkarımlar: Tek anterior portal kullanılarak yapılan instabilite cerrahisi sonuçları, literatürdeki klinik sonuçlar, postoperatif omuz hareketleri ve düşük rekürens oranları ile karşılaştırılabilir sonuçlara sa¬hiptir. Bu durum, uygun hasta seçiminin kullanılan portalden daha önemli olduğunu vurgulamaktadır. Bu daha az invaziv olan metodun cerrahi süreyi kısaltıyor olması 2 portale göre bir avantaj olarak değerlendirilebilir.

References

  • Bankart AS. The pathology and treatment of recurrent disloca- tion of the shoulder joint. Br J Surg 1938;26:23-9.
  • Bigliani LU, Pollock RG, Soslowsky LJ, Flatow EL, Pawluk RJ, Mow VC. Tensile properties of the inferior glenohumeral liga- ment. J Orthop Res 1992;10:187-97.
  • Mahiroğulları M, Ozkan H, Akyüz M, Uğraş AA, Güney A, Kuşkucu M. Comparison between the results of open and ar- throscopic repair of isolated traumatic anterior instability of the shoulder. Acta Orthop Traumatol Turc 2010;44:180-5.
  • Cole BJ, Warner JJ. Arthroscopic versus open Bankart repair for traumatic anterior shoulder instability. Clin Sports Med 2000;19:19-48.
  • Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 2006;88:1755-63.
  • Gartsman GM, Roddey TS, Hammerman SM. Arthroscopic treatment of anterior-inferior glenohumeral instability. Two to five-year follow-up. J Bone Joint Surg Am 2000;82-A:991-1003.
  • Burkhart SS, Debeer JF, Tehrany AM, Parten PM. Quantifying glenoid bone loss arthroscopically in shoulder instability. Ar- throscopy 2002;18:488-91.
  • Ee GW, Mohamed S, Tan AH. Long term results of arthroscopic Bankart repair for traumatic anterior shoulder instability. J Or- thop Surg Res 2011;6:28.
  • Provencher MT, Ghodadra N, Romeo AA. Arthroscopic man- agement of anterior instability: pearls, pitfalls, and lessons learned. Orthop Clin North Am 2010;41:325-37.
  • Atalar AC, Bilsel K, Eren I, Celik D, Cil H, Demirhan M. Modi- fied Latarjet procedure for patients with glenoid bone defect ac- companied with anterior shoulder instability. Acta Orthop Trau- matol Turc 2013;47:393-9.
  • Voos JE, Livermore RW, Feeley BT, Altchek DW, Williams RJ, Warren RF, et al. Prospective evaluation of arthroscopic bankart repairs for anterior instability. Am J Sports Med 2010;38:302-7.
  • Ahmed I, Ashton F, Robinson CM. Arthroscopic Bankart repair and capsular shift for recurrent anterior shoulder instability: functional outcomes and identification of risk factors for recur- rence. J Bone Joint Surg Am 2012;94:1308-15.
  • Porcellini G, Campi F, Pegreffi F, Castagna A, Paladini P. Pre- disposing factors for recurrent shoulder dislocation after ar- throscopic treatment. J Bone Joint Surg Am 2009;91:2537-42.
  • Chechik O, Maman E, Dolkart O, Khashan M, Shabtai L, Mozes G. Arthroscopic rotator interval closure in shoulder in- stability repair: a retrospective study. J Shoulder Elbow Surg 2010;19:1056-62.
  • Milano G, Grasso A, Santagada DA, Saccomanno MF, Deriu L, Fabbriciani C. Comparison between metal and biodegradable su- ture anchors in the arthroscopic treatment of traumatic anterior shoulder instability: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2010;18:1785-91.
  • Mauro CS, Voos JE, Hammoud S, Altchek DW. Failed anterior shoulder stabilization. J Shoulder Elbow Surg 2011;20:1340-50.
  • Shah AS, Karadsheh MS, Sekiya JK. Failure of operative treat- ment for glenohumeral instability: etiology and management. Arthroscopy 2011;27:681-94.
  • Hantes ME, Venouziou AI, Liantsis AK, Dailiana ZH, Malizos KN. Arthroscopic repair for chronic anterior shoulder instabil- ity: a comparative study between patients with Bankart lesions and patients with combined Bankart and superior labral anterior posterior lesions. Am J Sports Med 2009;37:1093-8.
  • Gutierrez V, Monckeberg JE, Pinedo M, Radice F. Arthroscopi- cally determined degree of injury after shoulder dislocation re- lates to recurrence rate. Clin Orthop Relat Res 2012;470:961-4.
  • Chambers KL, Kremen TJ, Snell CJ, Gamradt SC. Arthroscopic anterior shoulder stabilization in the beach chair position using trans-subscapularis drilling of the 5:30 anchor. Tech Should Elb Surg 2011;12:56-61.

Arthroscopic stabilization of anterior shoulder instability using a single anterior portal

Year 2015, Volume: 49 Issue: 1, 6 - 12, 19.03.2015
https://doi.org/10.3944/AOTT.2015.14.0035

Abstract

Objective: The aim of this study was to compare the effects of the use of a single anterior portal in the arthroscopic surgery treatment of traumatic anterior shoulder instability with those in the literature.

Methods: The study included 72 patients (60 males, 12 females; mean age: 23.9 years) who underwent surgery using a single arthroscopic anterior portal for the treatment of traumatic anterior shoulder instability between 2002 and 2011. Clinical outcomes were assessed using the Rowe and Oxford scales, forward flexion range and external rotation limitation. Redislocation was considered failure.

Results: Mean follow-up was 49.3 months. Bankart lesion was determined in 38 patients and Bankart and SLAP lesions in 34. An average of 3.7 (range: 2 to 5) anchors were used. Redislocation was observed in 4 (5.6%) patients in the postoperative period. Postoperative Rowe and Oxford scores were 93.4 and 42.6, respectively.

Conclusion: Instability surgery performed using a single arthroscopic anterior portal provided findings comparable with the literature regarding clinical outcomes, postoperative shoulder movements and low recurrence rates, emphasizing the importance of appropriate patient selection rather than the number of the portals. The use of a single portal is less invasive and reduces the surgical period.

References

  • Bankart AS. The pathology and treatment of recurrent disloca- tion of the shoulder joint. Br J Surg 1938;26:23-9.
  • Bigliani LU, Pollock RG, Soslowsky LJ, Flatow EL, Pawluk RJ, Mow VC. Tensile properties of the inferior glenohumeral liga- ment. J Orthop Res 1992;10:187-97.
  • Mahiroğulları M, Ozkan H, Akyüz M, Uğraş AA, Güney A, Kuşkucu M. Comparison between the results of open and ar- throscopic repair of isolated traumatic anterior instability of the shoulder. Acta Orthop Traumatol Turc 2010;44:180-5.
  • Cole BJ, Warner JJ. Arthroscopic versus open Bankart repair for traumatic anterior shoulder instability. Clin Sports Med 2000;19:19-48.
  • Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 2006;88:1755-63.
  • Gartsman GM, Roddey TS, Hammerman SM. Arthroscopic treatment of anterior-inferior glenohumeral instability. Two to five-year follow-up. J Bone Joint Surg Am 2000;82-A:991-1003.
  • Burkhart SS, Debeer JF, Tehrany AM, Parten PM. Quantifying glenoid bone loss arthroscopically in shoulder instability. Ar- throscopy 2002;18:488-91.
  • Ee GW, Mohamed S, Tan AH. Long term results of arthroscopic Bankart repair for traumatic anterior shoulder instability. J Or- thop Surg Res 2011;6:28.
  • Provencher MT, Ghodadra N, Romeo AA. Arthroscopic man- agement of anterior instability: pearls, pitfalls, and lessons learned. Orthop Clin North Am 2010;41:325-37.
  • Atalar AC, Bilsel K, Eren I, Celik D, Cil H, Demirhan M. Modi- fied Latarjet procedure for patients with glenoid bone defect ac- companied with anterior shoulder instability. Acta Orthop Trau- matol Turc 2013;47:393-9.
  • Voos JE, Livermore RW, Feeley BT, Altchek DW, Williams RJ, Warren RF, et al. Prospective evaluation of arthroscopic bankart repairs for anterior instability. Am J Sports Med 2010;38:302-7.
  • Ahmed I, Ashton F, Robinson CM. Arthroscopic Bankart repair and capsular shift for recurrent anterior shoulder instability: functional outcomes and identification of risk factors for recur- rence. J Bone Joint Surg Am 2012;94:1308-15.
  • Porcellini G, Campi F, Pegreffi F, Castagna A, Paladini P. Pre- disposing factors for recurrent shoulder dislocation after ar- throscopic treatment. J Bone Joint Surg Am 2009;91:2537-42.
  • Chechik O, Maman E, Dolkart O, Khashan M, Shabtai L, Mozes G. Arthroscopic rotator interval closure in shoulder in- stability repair: a retrospective study. J Shoulder Elbow Surg 2010;19:1056-62.
  • Milano G, Grasso A, Santagada DA, Saccomanno MF, Deriu L, Fabbriciani C. Comparison between metal and biodegradable su- ture anchors in the arthroscopic treatment of traumatic anterior shoulder instability: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2010;18:1785-91.
  • Mauro CS, Voos JE, Hammoud S, Altchek DW. Failed anterior shoulder stabilization. J Shoulder Elbow Surg 2011;20:1340-50.
  • Shah AS, Karadsheh MS, Sekiya JK. Failure of operative treat- ment for glenohumeral instability: etiology and management. Arthroscopy 2011;27:681-94.
  • Hantes ME, Venouziou AI, Liantsis AK, Dailiana ZH, Malizos KN. Arthroscopic repair for chronic anterior shoulder instabil- ity: a comparative study between patients with Bankart lesions and patients with combined Bankart and superior labral anterior posterior lesions. Am J Sports Med 2009;37:1093-8.
  • Gutierrez V, Monckeberg JE, Pinedo M, Radice F. Arthroscopi- cally determined degree of injury after shoulder dislocation re- lates to recurrence rate. Clin Orthop Relat Res 2012;470:961-4.
  • Chambers KL, Kremen TJ, Snell CJ, Gamradt SC. Arthroscopic anterior shoulder stabilization in the beach chair position using trans-subscapularis drilling of the 5:30 anchor. Tech Should Elb Surg 2011;12:56-61.
There are 20 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Mehmet Armangil This is me

H. Cagdas Basat This is me

Burak Akan This is me

Mert Karaduman This is me

Mehmet Demirtas This is me

Publication Date March 19, 2015
Published in Issue Year 2015 Volume: 49 Issue: 1

Cite

APA Armangil, M., Basat, H. C., Akan, B., Karaduman, M., et al. (2015). Arthroscopic stabilization of anterior shoulder instability using a single anterior portal. Acta Orthopaedica Et Traumatologica Turcica, 49(1), 6-12. https://doi.org/10.3944/AOTT.2015.14.0035
AMA Armangil M, Basat HC, Akan B, Karaduman M, Demirtas M. Arthroscopic stabilization of anterior shoulder instability using a single anterior portal. Acta Orthopaedica et Traumatologica Turcica. March 2015;49(1):6-12. doi:10.3944/AOTT.2015.14.0035
Chicago Armangil, Mehmet, H. Cagdas Basat, Burak Akan, Mert Karaduman, and Mehmet Demirtas. “Arthroscopic Stabilization of Anterior Shoulder Instability Using a Single Anterior Portal”. Acta Orthopaedica Et Traumatologica Turcica 49, no. 1 (March 2015): 6-12. https://doi.org/10.3944/AOTT.2015.14.0035.
EndNote Armangil M, Basat HC, Akan B, Karaduman M, Demirtas M (March 1, 2015) Arthroscopic stabilization of anterior shoulder instability using a single anterior portal. Acta Orthopaedica et Traumatologica Turcica 49 1 6–12.
IEEE M. Armangil, H. C. Basat, B. Akan, M. Karaduman, and M. Demirtas, “Arthroscopic stabilization of anterior shoulder instability using a single anterior portal”, Acta Orthopaedica et Traumatologica Turcica, vol. 49, no. 1, pp. 6–12, 2015, doi: 10.3944/AOTT.2015.14.0035.
ISNAD Armangil, Mehmet et al. “Arthroscopic Stabilization of Anterior Shoulder Instability Using a Single Anterior Portal”. Acta Orthopaedica et Traumatologica Turcica 49/1 (March 2015), 6-12. https://doi.org/10.3944/AOTT.2015.14.0035.
JAMA Armangil M, Basat HC, Akan B, Karaduman M, Demirtas M. Arthroscopic stabilization of anterior shoulder instability using a single anterior portal. Acta Orthopaedica et Traumatologica Turcica. 2015;49:6–12.
MLA Armangil, Mehmet et al. “Arthroscopic Stabilization of Anterior Shoulder Instability Using a Single Anterior Portal”. Acta Orthopaedica Et Traumatologica Turcica, vol. 49, no. 1, 2015, pp. 6-12, doi:10.3944/AOTT.2015.14.0035.
Vancouver Armangil M, Basat HC, Akan B, Karaduman M, Demirtas M. Arthroscopic stabilization of anterior shoulder instability using a single anterior portal. Acta Orthopaedica et Traumatologica Turcica. 2015;49(1):6-12.