Tüm -Yumuşak Sütür Ankor ve Konvansiyonel Metal Ankor ile Artroskopik Bankart Onarımı Sonrası Klinik ve Fonksiyonel Sonuçlarının Karşılaştırılması

Yıl 2019, Cilt: 9 Sayı: 3, 139 - 144, 30.09.2019

Mehmet Arıcan Yalçın Turhan

https://doi.org/10.33631/duzcesbed.584210

Öz

Aim: To compare the
clinical results after arthroscopic bankart repair with all-soft suture anchor
and conventional metal anchor in physically active patients with traumatic
anterior shoulder instability.

Material and Methods: A total of 32 patients who met eligibility criteria were included
between 2016 and 2017 years, for arthroscopic bankart repair in a single
orthopedic department. The patients were examined into 2 groups as 17 underwent
repair with 1.8 mm all-suture anchor with 2 (5 metric) Hi-Fi® sutures (Y-knot®
flex, Conmed, USA) (group 1), and 15 underwent repair with conventional
titanium 3.5 mm Suture Anchors with two preloaded ultrabraid sutures (TWINFIX,
Smith & Nephew) (group 2). Clinical and functional outcomes were assessed
pretreatment, and final follow-up using the American shoulder and Elbow
surgeons (ASES) score and the ROWE score.

Results: The mean
ASES score increased significantly in group 1 from 35.62±8.46 to 88.86±6.23
(p=0.0001) and had increased significantly in group 2 from 41.15±14.51 to
91.15±7.54 (p=0.0001). The mean ROWE score had increased significantly in group
1 from 48.82±11.25 to 85.00±10.00 (p=0.0001) and had significantly increased in
group 2 from 45.67±9.61 to 87.67±10.15 (p=0.0001). There was no significant
difference between the mean ASES scores of group 1 and group 2 (p=0.192,
p=0.353), and also no significant difference between the mean ROWE scores of
group 1 and group 2 (p=0.404, p=0.461) at pretreatment and final follow-up
respectively.

Conclusion: Arthroscopic bankart repair with an all-soft suture anchor demonstrated
comparable clinical and functional results as the conventional metal suture
anchor at short term follow-up.

Anahtar Kelimeler

Omuz eklemi, artroskopik cerrahi prosedür

Comparison of Clinical and Functional Results after Arthroscopic Bankart Repair with the All-Soft Suture Anchor and the Conventional Metal Anchor

Öz

Amaç: Travmatik
anterior omuz instabilitesi olan fiziksel olarak aktif hastalarda tüm yumuşak
sütür ankor ve konvansiyonel metal ankor ile artroskopik bankart tamirinin
klinik ve fonksiyonel sonuçlarının kıyaslanması amaçlanmıştır.

Gereç ve
Yöntemler:
2016-2017 yılları arasında, tek merkezde artroskopik bankart tamiri yapılan ve
dahil edilme kriterlerimize uyan 32 hasta değerlendirildi. 17 hastaya 1.8 mm
(Y-knot® flex, Conmed, USA) tüm yumuşak sütür ankor (grup 1) ve 15 hastaya ise
3.5 mm (TWINFIX, Smith & Nephew) konvansiyonel metal ankor (grup 2)
uygulandı. Klinik ve fonksiyonel sonuçlar tedaviden hemen önce ve son takipte
Amerikan omuz ve Dirsek cerrahları (ASES) skoru ve ROWE skoru ile
değerlendirildi.

Bulgular: Ortalama ASES
skoru grup 1’de 35.62±8.46'dan 88.86±6.23'e (p=0.0001) ve grup 2’de ise
41.15±14.51’den 91.15±7.54’e (p=0.0001) artmıştır. Ortalama ROWE skoru da grup
1’de 48.82±11.25'ten 85.00±10.00'a (p=0.0001) ve grup 2’de ise 45.67±9.61’den
87.67±10.15’e (p=0.0001) yükseldi. Grup 1 ve grup 2’nin tedavi öncesi ve son
takibinde ortalama ASES ve ROWE skorlarında fark yoktur (p=0.192, p=0.353 ve p=0.404,
p=0.461).

Sonuç: Tüm yumuşak
sütür ankor ile artroskopik bankart tamiri, kısa süreli takipte konvansiyonel
metal sütür ankor ile karşılaştırılabilir klinik ve fonksiyonel sonuçlar
göstermiştir.

Anahtar Kelimeler

Shoulder joint, arthroscopic surgical procedure

Kaynakça

• 1. Saper MG, Milchteim C, Zondervan RL, Andrews JR, Ostrander RV 3rd. Outcomes after Arthroscopic Bankart Repair in Adolescent Athletes Participating in Collision and Contact Sports. Orthop J Sports Med. 2017; 5(3): 2325967117697950.
• 2. Cole BJ, Warner JJ. Arthroscopic versus open Bankart repair for traumatic anterior shoulder instability. Clin Sports Med. 2000; 19(1): 19-48.
• 3. Aboalata M, Plath JE, Seppel G, Juretzko J, Vogt S, Imhoff AB. Results of Arthroscopic Bankart Repair for Anterior-Inferior Shoulder Instability at 13-Year Follow-up. Am J Sports Med. 2017; 45(4): 782-7.
• 4. Fleega BA. Overlap arthroscopic Bankart repair: Reconstruction to the glenoid rim. Arthroscopy. 2002; 18(4): E18.
• 5. Ee GW, Mohamed S, Tan AH. Long term results of arthroscopic Bankart repair for traumatic anterior shoulder instability. J Orthop Surg Res. 2011; 6: 28.
• 6. Brown L, Rothermel S, Joshi R, Dhawan A. Recurrent Instability after Arthroscopic Bankart Reconstruction: A Systematic Review of Surgical Technical Factors. Arthroscopy. 2017; 33(11): 2081-92.
• 7. Romeo AA, Cohen BS, Carreira DS. Traumatic anterior shoulder instability. Orthop Clin North Am. 2001; 32(3): 399-409.
• 8. Visscher LE, Jeffery C, Gilmour T, Anderson L, Couzens G. The history of suture anchors in orthopaedic surgery. Clin Biomech (Bristol, Avon). 2019; 61: 70-8.
• 9. Tan CK, Guisasola I, Machani B, Kemp G, Sinopidis C, Brownson P, et al. Arthroscopic stabilization of the shoulder: A prospective randomized study of absorbable versus non-absorbable suture anchors. Arthroscopy. 2006; 22(7): 716-20.
• 10. Bek D, Ege T, Erdem Y, Tunay S. Severe cartilage loss caused by metallic anchors in surgical treatment of a Bankart lesion: Report of three cases. Eklem Hastalik Cerrahisi. 2015; 26(2): 116-9.
• 11. Barber FA, Herbert MA, Hapa O, Rapley JH, Barber CA, Bynum JA et al. Biomechanical analysis of pullout strengths of rotator cuff and glenoid anchors: 2011 update. Arthroscopy. 2011; 27(7): 895-905.
• 12. Ng DZ, Kumar VP. Arthroscopic Bankart repair using knot-tying versus knotless suture anchors: Is there a difference? Arthroscopy. 2014; 30(4): 422-7.
• 13. Mazzocca AD, Chowaniec D, Cote MP, Fierra J, Apostolakos J, Nowak M, et al. Biomechanical evaluation of classic solid and novel all-soft suture anchors for glenoid labral repair. Arthroscopy. 2012; 28(5): 642-8.
• 14. Nagra NS, Zargar N, Smith RD, Carr AJ. Mechanical properties of all-suture anchors for rotator cuff repair. Bone Joint Res. 2017; 6(2): 82-9.
• 15. Lee JH, Itami Y, Hedayati B, Bitner B, McGarry MH, Lee TQ, et al. Biomechanical effects of position and angle of insertion for all-suture anchors in arthroscopic Bankart repair. Clin Biomech (Bristol, Avon). 2018; 60: 45-50.
• 16. Pötzl W, Witt KA, Hackenberg L, Marquardt B, Steinbeck J. Results of suture anchor repair of anteorior-inferior shoulder instability: A prospective clinical study of 85 shoulders. J Shoulder Elbow Surg. 2003; 12(4): 322-6.
• 17. Lee JH, Park I, Hyun HS, Kim SW, Shin SJ. Comparison of Clinical Outcomes and Computed Tomography Analysis for Tunnel Diameter after Arthroscopic Bankart Repair with the All-Suture Anchor and the Biodegradable Suture Anchor. Arthroscopy. 2019; 35(5): 1351-8.
• 18. Lee KH, Soeharno H, Chew CP, Lie D. Arthroscopic Bankart repair augmented by plication of the inferior glenohumeral ligament via horizontal mattress suturing for traumatic shoulder instability. Singapore Med J. 2013; 54(10): 555-9.
• 19. Hoffmann F. Arthroscopic Bankart operation using absorbable suture anchors. Oper Orthop Traumatol. 2006; 18(2): 101-19.
• 20. Torrance E, Clarke CJ, Monga P, Funk L, Walton MJ. Recurrence after Arthroscopic Labral Repair for Traumatic Anterior Instability in Adolescent Rugby and Contact Athletes. Am J Sports Med. 2018; 46(12): 2969-74.
• 21. Randelli P, Ragone V, Carminati S, Cabitza P. Risk factors for recurrence after Bankart repair a systematic review. Knee Surg Sports Traumatol Arthrosc. 2012; 20(11): 2129-38.
• 22. Barber FA. Complications of Biodegradable Materials: Anchors and Interference Screws. Sports Med Arthrosc Rev. 2015; 23(3): 149-55.
• 23. Turkmen I, Altun G. Increasing the deltoid muscle volume positively affects functional outcomes after arthroscopic rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2019; 27(1): 259-66.