Ters omuz protezi: Kısa dönem radyolojik ve klinik sonuçlarımız

Yıl 2014, Cilt: 48 Sayı: 1, 25 - 31, 15.03.2014

Ata Can Atalar Ahmet Salduz Hilal Cil Mustafa Sungur Derya Celik Mehmet Demirhan

Öz

Amaç: Bu çalışmada rotator manşet yırtığı artropatisi sebebiyle ters omuz protezi uyguladığımız hastalarımızın kısa dönem radyolojik ve klinik sonuçlarını incelemeyi amaçladık.
Çalışma planı: 2009–2010 tarihleri arasında manşet yırtığına bağlı omuz artrozu olan 2 erkek, 12 kadın toplam 14 hastaya ters omuz protezi uygulandı. Hastaların ortalama yaşı 74 yıl (57–80) ve ortalama takip süresi 32 ay (21–40) idi. Hastalar ameliyat öncesinde ve son kontrollerinde radyolojik yöntemlerle ve eklem hareket açıklığı, Quick DASH, Constant, VAS skorları ile değerlendirildi.
Bulgular: Ameliyat öncesi ortalama sırasıyla 44, 41 ve 21 derece olan aktif öne fleksiyon, abdüksiyon ve dış rotasyon dereceleri son kontrollerinde sırasıyla ortalama 149, 105 ve 37 derece olarak ölçüldü. Ortalama Quick DASH skoru ameliyat öncesi 59.1 iken son kontrollerinde 36.1 olduğu izlendi. Ortalama Constant skoru ameliyat öncesi 20.7 iken son kontrollerinde 58.9’a yükseldi. VAS değerlendirmesi ameliyat öncesi ortalama 7 iken son kontrollerinde 1.2’ye geriledi. Akromion humerus arası mesafe ölçümleri ameliyat öncesi ortalama 5.3 iken ameliyat sonrası ortalama 23.1’e yükseldi. Hastaların hiçbirinde erken ve geç büyük komplikasyon izlenmedi.
Çıkarımlar: İleri evredeki rotator manşet yırtığı artropatisi hastalarında ters omuz protezi uygulaması ve uygun rehabilitasyon protokolü ile ağrı ve fonksiyon açısından anlamlı düzelme sağlanabilir.

Anahtar Kelimeler

Ters omuz artroplastisi; rotator manşet yırtığı.

Reverse shoulder arthroplasty: radiological and clinical short–term results

Öz

Objective: The aim of this study was to examine the radiological and clinical short term results of the patients who underwent reverse shoulder arthroplasty for rotator cuff arthropathy.
Methods: The study included 14 (2 male, 12 female) patients who underwent reverse shoulder arthroplasty for rotator cuff arthropathy between 2009 and 2010. The mean age of the patients was 74 (57–80) years and the mean follow–up period was 32 (21–40) months. Radiological methods as well as the range of motion, Quick DASH, Constant and VAS scores were used for the evaluation of patients preoperatively and at last the follow–up.
Results: Mean active forward flexion, abduction and external rotation increased respectively from 44, 41 and 21 degrees preoperatively to 149, 105 and 37 degrees at the last follow–up. The mean QuickDash score was 59.1 degrees preoperatively, and 36.1 degrees at the last follow–up visit. The mean Constant score increased from 20.7 preoperatively to 58.9 at the last follow–up visit. The mean VAS score decreased from 7 preoperatively to 1.2 at the last follow–up visit. The mean acromion–humeral head distance increased from 5.3 mm preoperatively to 23.1 mm postoperatively. None of the patients had major complications.
Conclusion: Reverse shoulder arthroplasty in patients with advanced stage rotator cuff tear arthropathy ensure significant improvement in terms of pain and function with the help of an appropriate rehabilitation protocol.

Anahtar Kelimeler

Reverse shoulder, arthroplasty, rotator cuff tear

Kaynakça

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