ROTATOR MANŞET YARALANMALARINA EŞLİK EDEN EKLEM İÇİ PATOLOJİLER

Abstract

Giriş: Rotator manşet yaralanmaları özellikle yaşlı hastalarda sık görülen sorunlardandır. Bu durum tek başına görülebileceği gibi çeşitli eklem içi patolojilerle birlikte de bulunabilir. Çalışmamızda rotator manşet yırtığı nedeniyle artroskopik cerrahi tedavi uygulanan hastalardaki eklem içi patolojiler değerlendirildi. Materyal ve Metod: Rotator cuff yırtığı nedeniyle artroskopik tamir uygulanan 104 hasta (65 kadın, 39 erkek) çalışmaya dahil edildi. Hastaların ortalama yaşı 50.3 (dağılım 29-70) idi. Ameliyat öncesi grafi ve MRG görüntüleri ile ameliyat sırasındaki bulgular karşılaştırıldı. Bulgular: Ortalama takip süresi 23.9 (dağılım 12-40) ay idi. Ameliyat öncesi MRG sonuçlarına göre hastaların % 63.4’ünde, ameliyat sırasındaki video görüntüleri incelendiğinde ise hastaların % 73.8’inde rotator manşet yırtığına eşlik eden bir eklem içi patoloji saptandı. Artroskopik cerrahi sırasındaki kayıtlarda, MRG değerlendirmelerine göre SLAP lezyonlarının belirgin şekilde fazla olduğu saptandı (p<0.05). Sonuç: Rotator manşet yırtıkları eşlik eden eklem içi patolojilerle birlikte bulunabilir. Artroskopik cerrahi ile bunların büyük kısmına hem tanı konur, hem de tedavi edilir. SLAP lezyonları rotator manşet yırtıklarına eşlik eden en sık eklem içi patolojilerdendir ve MRG ile teşhisi zordur. Açık rotator manşet yırtığı tamiri yapılacaksa bile diagnostik artroskopi yapılması, SLAP lezyonlarının atlanmaması açısından önemlidir.

Keywords

• Omuz artroskopisi
• rotator manşet yırtığı
• superolateralantero-posterior lezyon

THE INTRAARTICULAR PATHOLOGIES ASSOCIATED TO ROTATOR CUFF INJURIES

Abstract

Introduction: Rotator cuff injuries were seen especially in elderly patients. It can be seen alone or accompanying with intraarticular problems. We evaluate the intraarticular problems associated to rotator cuff injuries in arthroscopic shoulder surgery. Materials and Methods: 104 patients (65 female, 39 male) who were operated arthroscopically because of rotator cuff injury were included in our study. The mean age of the patients was 50,3 (range 29-70). Intraarticular problems and cuff tears were evaluated from preoperative radiographies and MRI and the intraoperative video record and they were compared. Results: The mean follow up was 23,9 (range 12-40) months. 63.4% of the patients (66 patients) had an intraarticular pathology accompanying rotator cuff injury according to the radiological evaluation, whereas 73.8% of the patients (76 patients) had an intraarticular pathology in the arthroscopic records. SLAP lesions accompanying rotator cuff injuries were found valuably high in the arthroscopic records compared to preoperative MRI evaluation (p<0.05). Conclusion: SLAP lesions can accompany rotator cuff lesions and they were difficult to diagnose preoperatively. Arthroscopic surgery is useful to detect the SLAP lesions in rotator cuff repair. Diagnostic arthroscopy must be performed to avoid undiagnosed SLAP lesions even in open surgery.

Keywords

• Shoulder arthroscopy
• rotator cuff tear
• superolatealanteroposterior lesion

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