TRAVMATİK ANTERİOR OMUZ İNSTABİLİTESİNDE AÇIK VE ARTROSKOPİK BANKART TAMİRİ SONUÇLARININ KARŞILAŞTIRILMASI Comparison of Open and Arthroscopic Bankart Repair Results in Traumatic Anterior Shoulder Instability

Year 2017, Volume: 7 Issue: 4, 61 - 65, 13.12.2017

Hicabi Sezgin Alper Çıraklı Çağatay Zengin Ahmet Pişkin Erdal Uzun

Abstract

ÖZET

Amaç: Travmatik anterior omuz instabilitesi cerrahi tedavisinde açık ve artroskopik Bankart tamirinin

klinik sonuçlarının karşılaştırılması amaçlandı.

Materyal ve Metod: Ocak 2005 ile Ocak 2013 yılları arasında tekrarlayan anterior omuz instabilitesi

nedeniyle cerrahi tedavi uygulanan 23 hastadan son kontrolleri yapılan 20 hasta (17 erkek, 3 kadın)

çalışmaya dahil edildi. Hastaların 10’una (ort. yaş 30, dağılım 17-43) açık Bankart tamiri, 10’una (ort. yaş

21, dağılım 18-49) artroskopik Bankart tamiri uygulandı. Ağrı değerlendirmesi vizüel analog skalasına

(VAS) göre yapılırken klinik sonuçlar Rowe skalası kullanılarak değerlendirildi. Ameliyat sonrası ortalama

takip süresi açık tamir grubunda 37.4±27.1 ay iken, artroskopik tamir grubunda 23±6.9 ay idi. İstatistiksel

değerlendirmede Shapiro-Wilk testi ile Mann-Whitney U testi kullanıldı.

Bulgular: VAS skoru açık tamir grubunda 5.7±2.5, artroskopik tamir grubunda 4.1±1.9, Rowe skoru açık

tamir grubunda 97.5 (dağılım 80-100), artroskopik tamir grubunda 95 (dağılım 50-100) olarak bulundu.

Klinik sonuçlar açık tamir grubunda 9 hastada (%90) mükemmel, bir hastada (10%) iyi iken, artroskopik

tamir grubunda 8 hastada (80%) mükemmel, bir hastada (10%) iyi, bir hastada (10%) kötü olarak bulundu.

Açık grupta 2 hastada, artroskopik grupta ise 5 hastada dış rotasyon kısıtlılığı gözlendi. İki grup

arasında VAS skoru, Rowe skoru ve eklem hareket açıklığı bakımından istatistiksel olarak anlamlı fark

görülmedi (p>0.05).

Sonuç: Çalışmamızda artroskopik tamir ile açık tamir sonuçları, son yıllardaki çalışmalarla paralel olarak

eşdeğer bulundu. Ancak artroskopik tamirin cerrahi tecrübe ve tamir yöntemlerinin gelişmesiyle, postoperatif

hasta konforu ve rehabilitasyon kolaylığı nedeniyle avantajlı olduğu kanısındayız.

Anahtar Sözcu¨kler: Bankart; İnstabilite; Omuz; Cerrahi; Açık; Artroskopi

ABSTRACT

Objective: The purpose of the study was to compare the clinical results of open and arthroscopic bankart

repair in the surgical treatment of traumatic anterior shoulder instability.

Material and Methods: Out of 23 patients who had surgical treatment due to recurrent anterior

shoulder instability between January 2005 and January 2013, 20 patients (17 men, 3 women) whose last

controls were made were included in the study. Open Bankart repair was applied on 10 (average age 30,

ranging between 17 and 43) patients and arthroscopic Bankart repair was applied on 10 (average age 21,

ranging between 18 and 49) patients. While pain was assessed according to visual analog scale (VAS),

clinical results were assessed by using Rowe scale. Average postoperation follow-up time was 37.4±27.1

months in the open repair group, while it was 23±6.9 months in the arthroscopic repair group. Shapiro-

Wilk test and Mann-Whitney U test were used for statistical analysis.

Results: VAS score was 5.7±2.5 in the open surgery group, while it was 4.1±1.9 in the arthroscopic group

and Rowe score was 97.5 (ranging between 80 and 100), while it was 95 (ranging between 50 and 100) in

the arthroscopic repair group. Clinical results were perfect in 9 (90%) patients in the open surgery group,

while they were good in 1 (10%) patient. In the arthroscopic repair group, clinical results were perfect in

8 (80%) patients, good in 1 (10%) patient and bad in 1 (10%) patient. Limitation of external rotation was

seen in 2 patients in the open group and in 5 patients in the arthroscopic group. No statistical difference

was found between the two groups in terms of VAS score, Rowe score and range of motion (p>0.05).

Conclusion: The results of arthroscopic repair and open repair in our study were found to be in parallel

with the results of recent studies. However, with the developments in repair methods and surgical

experiences, we are of the opinion that arthroscopic repair is more advantageous due to postoperative

patient comfort and ease of rehabilitation.

Keywords: Bankart; İnstability; Shoulder; Surgery; Open; Arthroscopy

Keywords

TRAVMATİK ANTERİOR OMUZ İNSTABİLİTESİNDE AÇIK VE ARTROSKOPİK BANKART TAMİRİ SONUÇLARININ KARŞILAŞTIRILMASI Comparison of Open and Arthroscopic Bankart Repair Results in Traumatic Anterior Shoulder Instability

References

• 1. Ee GW, Mohamed S, Tan AH. Long term results of arthroscopic Bankart repair for traumatic anterior shoulder instability. J Orthop Surg Res. 2011;14(6):28. 2. Shah AS, Karadsheh MS, Sekiya JK. Failure of operative treatment for glenohumeral instability: etiology and management. Arthroscopy. 2011;27(5):681-94. 3. Hintermann B, Gächter A. Arthroscopic findings after shoulder dislocation. Am J Sports Med. 1995;23(5):545-51. 4. Tuncay İ, Tosun N, Akpınar F. Preliminary results of Bankart repair of anterior shoulder instabilities with suture anchors. Acta Orthop Traumatol Turc. 2000;34:368-73. 5. Kim SH, Ha KI, Kim SH. Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique. Arthroscopy. 2002;18(7):755-63. 6. Geiger DF, Hurley JA, Tovey JA, Rao JP. Results of arthroscopic versus open Bankart suture repair. Clin Orthop Relat Res. 1997;(337):111-7. 7. Cole BJ, L’Insalata J, Irrgang J, Warner JPJ. Comparison of arthroscopic and open anterior shoulder stabilization. J Bone Joint Surg. 2000;82-A(8):1108-14. 8. Gartsman GM, Roddey TS, Hammerman SM. Arthroscopic treatment of anterior-inferior glenohumeral instability. J Bone Joint Surg. 2000;82-A(7):991-1003. 9. Levine WN, Arroyo JS, Pollock RG, Flatow EL, Bigliani LU. Open revision stabilization surgery for recurrent anterior glenohumeral instability. Am J Sports Med. 2000;28(2):156-60. 10. Cole BJ, Romeo AA. Arthroscopic shoulder stabilization with suture anchors: technique, technology, and pitfalls. Clin Orthop Relat Res. 2001;(390):17-30.