OMUZ ANTERİOR KAPSÜLOLABRAL TAMİR YAPILAN BİREYLERDE CERRAHİ ÖNCESİ RİSK FAKTÖRLERİNİN FONKSİYONEL SONUÇLARA ETKİSİ

Öz

Giriş: Yetersiz fonksiyonel kapasite, omuz stabilizasyon cerrahisi yapılan bireylerde, cerrahi sonrası meydana gelen tekrarlı dislokasyonlar için önemli bir risk faktörüdür. Amaç: Cerrahi öncesi risk faktörlerinin, omuz stabilizasyon cerrahisi olan bireylerin fonksiyonel kapasitesine etkisini araştırmak. Yöntem: Çalışmaya artroskopik omuz anterior kapsülolabral tamiri (AOAKT) yapılan 24 birey dahil edildi (yaş: 18-51 yıl arası, boy: vücut ağırlığı:). Bireyler, cerrahi öncesi dislokasyon sayısına ve cerrahiye kadar geçen süreye göre 2 farklı şekilde gruplandırıldı. Cerrahiye kadar geçen süreye göre; erken tamir (6 aydan kısa sürede cerrahi olanlar, n=14) ve geç tamir (6 aydan daha uzun sürede cerrahi olanlar, n=12), dislokasyon sayısına göre: bir dislokasyon (n=8) ve çoklu dislokasyon (n=18) yaşayanlar. Bireylerin rotator kılıf kas kuvvetleri, cerrahi sonrası 6. ayda izokinetik sistem kullanılarak 60/sn ve 180/sn açısal hızlarda ölçüldü. Omuz eklem fonksiyonu kapalı kinetik halka üst ekstremite stabilizasyon (KKHÜST) testi kullanılarak test edildi. Oluşturulan gruplarda, kas kuvveti ve omuz fonksiyonu hem grup içi hem de gruplar arasında Will-Coxon ve Mann Whitney-U testleri ile ayrı ayrı analiz edildi. Bulgular: Geç cerrahi tamir yapılan bireylerde 60/sn (p=0,008) ve 180/sn (p=0,02) açısal hızlarda cerrahi yapılan tarafta, cerrahi yapılmayan tarafa göre eksternal rotator kas kuvveti daha düşüktü. Dislokasyon sayısına göre oluşturulan gruplamada ise, her iki grupta 60/sn ve 180/sn açısal hızlarda, cerrahi yapılan tarafta, cerrahi yapılmayan tarafa göre omuz internal rotator kas kuvveti daha düşüktü. Sonuç: Omuz instabilitesi olanlarda geç cerrahi tamir yapılması fonksiyonelliği negatif etkileyebilir. Erken cerrahi tamir yapılması ise daha hızlı toparlanmayı sağlar.

Anahtar Kelimeler

• Omuz instabilitesi
• spora dönüş
• rotator kılıf

The effects of Pre-operative Risk Factors on Functional Outcomes on Patients with Shoulder Stabilization Surgery

Abstract

Abstract: Poor shoulder functional capacity is one of the risk factors for the re-dislocation after shoulder stabilization surgery. Aim: To investigate the effects of pre-operative risk factor on the functional capacity of the patients with shoulder stabilization surgery. Method: Twenty-four patients with arthroscopic anterior shoulder stabilization surgery (age: between 18-51 years, weight: height) (AASSS) were included to the study. Patients were divided into groups based the elapsed time until surgery; early repair (surgical repair within the six months after initial dislocation, n=14) or delayed repair (surgical repair after six months from the initial surgery, n=12), and number of pre-operative dislocations; one dislocation (n=8) or multiple dislocations (n=18). Rotator cuff strength were measured using isokinetic device at 60/sec and 180/sec angular velocities at the post-operative six months. Closed kinetic chain upper extremity stability test (CKCUEST) was use to assess the shoulder function. RC strength and shoulder function were analyzed using Wilcoxon and Mann-Whitney U test in both groups. Results: There were decreased RC strength on the operated side compared to the non-operated side at 60/sec (p=0,008) and 180/sec (p=0,02) angular velocities on patients with delayed repair. Internal rotator strength was decreased on the operated side compared to the non-operated side at 60/sec and 180/sec angular velocities on both one-time dislocation and multiple dislocation groups. Conclusion: Delayed surgical repair may affect negatively post-operative functional outcomes on patients with AASSS. In contrast, early surgical repair after the initial dislocation provide faster recovery.

Keywords

• shoulder instability
• return to sport
• rotator cuff

Kaynakça

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