Anterior omuz instabilitesinde artroskopikstabilizasyon: Tek anterior portal

Öz

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.

Anahtar Kelimeler

• Artroskopi; Bankart; tek anterior portal.

Arthroscopic stabilization of anterior shoulder instability using a single anterior portal

Öz

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.

Anahtar Kelimeler

• Arthroscopy
• Bankart
• shoulder instability
• single anterior portal

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