Manşet Yırtığı Artropatisi ve Kompleks Proksimal Humerus Kırıkları Olan Hastalarda Ters Omuz Artroplastisinin Kısa Dönem Sonuçları

Year 2025, Issue: Early Access

Zekeriya Okan Karaduman

https://doi.org/10.18678/dtfd.1718669

Abstract

Amaç: Bu çalışmanın amacı, manşet yırtığı artropatisi ve kompleks proksimal humerus kırıkları olan hastalarda ters omuz artroplastisinin (TOA) kısa dönem klinik ve fonksiyonel sonuçlarını değerlendirmektir.
Gereç ve Yöntemler: Ocak 2019 ile Temmuz 2024 tarihleri arasında üçüncü basamak bir tek merkezde TOA uygulanan 15 hastanın verileri geriye dönük olarak incelendi. Klinik değerlendirmeler ameliyat öncesinde ve ameliyat sonrası 3. ve 6. aylarda yapıldı. Ağrı, görsel analog skala (visual analog scale, VAS) ile değerlendirildi ve fonksiyonel durum quick disabilities of the arm, shoulder and hand (Quick DASH) anketi ile ölçüldü. Omuz eklem hareket açıklığı (range of motion, ROM) için abdüksiyon, fleksiyon ve dış rotasyon kaydedildi. İç rotasyon, ulaşılan vertebral seviyeye göre değerlendirildi.
Bulgular: Ortalama yaş 74,3±6,8 yıl olup, hastaların %80’i (n=12) kadındı. En sık endikasyon manşet yırtığı artropatisi idi (%86,7, n=13). Ameliyat sonrası 6. ayda ortalama VAS skoru 7,9±1,2'den 2,3±1,1'e anlamlı şekilde iyileşirken (p<0,001), Quick DASH skoru 78,2±6,5'ten 27,6±9,3'e geriledi (p<0,001). Ameliyat sonrası abdüksiyon ve fleksiyon 68,4±17,3° ve 71,2±16,1°'den sırasıyla 115,6±21,2° ve 105,7±18,5°'ye yükseldi (p<0,001). Takip sırasında herhangi bir majör komplikasyon gözlenmedi.
Sonuç: TOA, nadir ve karmaşık bir hasta grubunda ağrı azalması, fonksiyonel kapasite ve ROM açısından kısa vadeli önemli iyileşmeler sağlamaktadır. Bu bulgular, onarılamaz rotator manşet patolojisi ve karmaşık kırıkları olan, özenle seçilmiş vakalarda güvenilir bir cerrahi seçenek olarak kullanımını desteklemektedir.

Keywords

Ters omuz artroplastisi , manşet yırtığı artropatisi , proksimal humerus kırığı , eklem hareket açıklığı , kısa vadeli sonuçlar

Short-Term Outcomes of Reverse Shoulder Arthroplasty in Patients with Cuff Tear Arthropathy and Complex Proximal Humerus Fractures

Abstract

Aim: This study aimed to evaluate the short-term clinical and functional outcomes of reverse shoulder arthroplasty (RSA) in patients with cuff tear arthropathy and complex proximal humeral fractures.
Material and Methods: A retrospective review was conducted on 15 patients who underwent RSA between January 2019 and July 2024 at a single tertiary center. Clinical evaluations were performed preoperatively and at 3 and 6 months postoperatively. Pain was assessed using the visual analog scale (VAS), and functional status was measured using the quick disabilities of the arm, shoulder and hand (Quick DASH) questionnaire. Shoulder range of motion (ROM) was recorded in abduction, flexion, and external rotation. Internal rotation was assessed by the vertebral level reached.
Results: The mean age was 74.3±6.8 years, and 80% (n=12) of the patients were female. Cuff tear arthropathy was the most common indication (86.7%, n=13). At 6 months postoperatively, the mean VAS score improved significantly from 7.9±1.2 to 2.3±1.1 (p<0.001), while the Quick DASH score decreased from 78.2±6.5 to 27.6±9.3 (p<0.001). Abduction and flexion increased from 68.4±17.3° and 71.2±16.1° to 115.6±21.2° and 105.7±18.5° postoperatively, respectively (p<0.001). No major complications were observed during follow-up.
Conclusion: RSA provides substantial short-term improvements in pain reduction, functional capacity, and ROM in a rare and complex patient group. These findings support its use as a reliable surgical option in carefully selected cases with irreparable rotator cuff pathology and complex fractures.

Keywords

Reverse shoulder arthroplasty , cuff tear arthropathy , proximal humerus fracture , range of motion , short-term outcomes

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