Rotator Manşet Onarımında İki Farklı Tekniğin Fonksiyonel ve Klinik Sonuçlarının Karşılaştırmalı Olarak İncelenmesi: Sütür Ankor ve Transosseöz Sharc-FT

Yıl 2020, Cilt: 10 Sayı: 1, 36 - 42, 31.01.2020

Zekeriya Okan Karaduman , Mehmet Arıcan , Ozan Turhal , Yalçın Turhan , Kazım Solak , Mehmet Orçun Akkurt , Şengül Cangür

https://doi.org/10.33631/duzcesbed.664066

Öz

Amaç: Bu çalışmada,
rotator manşet yırtıklarında sütür ankor ve transosseöz sharc-FT fiksasyon
seçeneklerinin mini-açık onarımının fonksiyonel ve klinik sonuçlarını
karşılaştırmayı amaçladık.

Gereç ve
Yöntemler:
Ocak 2010 - Temmuz 2016 arasında Düzce Üniversitesi Hastanesi Ortopedi ve
Travmatoloji Kliniğinde ve Düzce Devlet Hastanesi Ortopedi ve Travmatoloji
Kliniğinde Ocak 2010 - Temmuz 2016 tarihleri arasında 60 hasta ameliyat edildi.
30 hasta sütür ankor (grup 1) ile tamir edilen ve 30 Transosseöz Sharc -FT®
(grup 2) ile ameliyat edilen hastalar karşılaştırıldı. Preoperatif ve
postoperatif omuz hareket açıklığı, VAS skoru, Constant omuz skoru, Oxford omuz
skoru ve Q-DASH omuz skoru grup 1 ve 2 hastada değerlendirildi.

Bulgular: Katılımcıların
%62’si erkek, %38'si kadındı. Gruplara göre cinsiyet dağılımı homojendi (P=0,426).
Deneklerin yaş ortalaması 57,35 ± 8,69 (41-78) idi. Gruplar arasında yaş
ortalaması açısından anlamlı fark yoktu (P=0,232). Post-hoc testine göre,
ameliyat sonrası Constant skoru Grup 2'de Grup 1'den anlamlı olarak yüksek
bulundu (P<0,001).

Sonuç: Transosseöz
Sharc-FT fiksasyon malzemesi ile rotator manşet onarımının, sütür ankor’a göre
sıkı stabilite sağladığı ve üstün fonksiyonel, radyolojik ve ağrı skorlarına
sahip olduğu sonucuna vardık. Ayrıca, erken rehabilitasyonun Transosseöz Sharc-FT
kullanılarak diğer tespit seçeneklerine göre rotator manşet onarımı geçiren
hastalar için bir avantaj olduğu sonucuna vardık.

Anahtar Kelimeler

Rotator manşet yırtığı, transosesöz dikiş, tek sıra dikiş

Comparative Study of the Functional and Clinical Outcomes of Two Different Rotator Cuff Repair Techniques: Suture Anchor versus Transosseous Sharc-FT

Öz

Aim: The aim
of the present study was to compare the functional and clinical outcomes of
suture anchor and transosseous Sharc-FT fixation options in mini-open repair of
rotator cuff tears.

Material and Methods: Between January 2010 and July 2016, 60 patients were operated on in the
Orthopedics and Traumatology Clinics of Duzce University Hospital and Duzce
State Hospital. Thirty patients in whom repair was performed with suture anchor
(Group 1) and 30 patients in whom repair was performed with Transosseous
Sharc-FT® (Group 2) were compared. Preoperative and postoperative shoulder
ranges of motion, the visual analog scale scores, constant shoulder scores,
Oxford shoulder scores, and Q-DASH shoulder scores were evaluated in Group 1
and Group 2 patients.

Results: A total
of 62% of the participants were male and 38% were female. Gender distribution
was homogeneous in both groups (P=0.426). The mean age of the subjects was
57.35 ± 8.69 (41-78) years. No significant difference was noted between the
groups in terms of mean age (P=0.232). On the basis of the post-hoc test
results, the postoperative constant score was significantly higher in Group 2 compared
with that in Group 1 (P<0.001).

Conclusion: Rotator cuff repair using transosseous Sharc-FT fixation material
provides tighter stability compared with suture anchor and has superior
functional, radiological, and pain scores. Furthermore, early rehabilitation is
another advantage of using Transosseous Sharc-FT in patients who prefer
undergoing rotator cuff repair over other fixation options.

Anahtar Kelimeler

Rotator cuff tears, transosseous suture, single-row suture

Kaynakça

• 1. Gerber C, Schneeberger AG, Beck M, Schlegel U. Mechanical strength of repairs of the rotator cuff. J Bone Joint Surg Br. 1994; 76(3): 371-80.
• 2. Buess E, Steuber KU, Waibl B. Open versus arthroscopic rotator cuff repair: a comparative view of 96 cases. Arthroscopy. 2005; 21(5): 597-604.
• 3. Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004; 86(2): 219-24.
• 4. Harryman DT 2nd, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA 3rd. Repairs of the rotator cuff: correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991; 73(7): 982-9.
• 5. Morse K, Davis AD, Afra R, Kaye EK, Schepsis A, Voloshin I. Arthroscopic versus mini-open rotator cuff repair: a comprehensive review and meta-analysis. Am J Sports Med. 2008; 36: 1824-8.
• 6. Razmjou H. Evaluating equivalency of treatment effectiveness: the example of arthroscopic and mini-open rotator cuff repairs. Hand Clin.2009; 25(1): 67-70.
• 7. Brady PC, Arrigoni P, Burkhart SS. Evaluation of residual rotator cuff defects after invivo single- versus double-row rotator cuff repairs. Arthroscopy. 2006; 22(10): 1070-5.
• 8. Brown MJ, Pula DA, Kluczynski MA, Mashtare T, Bisson LJ. Does suture technique affect re-rupture in arthroscopic rotator cuff repair? A meta-analysis. Arthroscopy. 2015; 31(8): 1576-82.
• 9. Burkhart SS, Adams CR, Burkhart SS, Schoolfield JD. A biomechanical comparison of 2 techniques of footprint reconstruction for rotator cuff repair: the SwiveLock-Fiber Chain construct versus standard double-row repair. Arthroscopy. 2009; 25(3): 274-81.
• 10. Garofalo R, Castagna A, Borroni M, Krishnan SG. Arthroscopic transosseous (anchorless) rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2012; 20(6): 1031-5.
• 11. Goutallier D, Postel JM, Radier C, Bernageau J, Zilber S. Long-term functional and structural outcome in patients with intact repairs 1 year after open transosseous rotator cuff repair. J Shoulder Elbow Surg. 2009; 18(4): 521-8.
• 12. Kim KC, Rhee KJ, Shin HD, Kim YM. Arthroscopic transosseous rotator cuff repair. Orthopedics. 2008; 31(4): 327-30.
• 13. Baudi P, Rasia Dani E, Campochiaro G, Rebuzzi M, Serafini F, Catani F. The rotator cuff tear repair with a new arthroscopic transosseous system: the Sharc-FT(®). Musculoskelet Surg. 2013; 97(Supp l): 57-61.
• 14. Kuroda S, Ishige N, Mikasa M. Advantages of arthroscopic transosseous suture repair of the rotator cuff without the use of anchors. Clin Orthop Relat Res. 2013; 471(11): 3514-22.
• 15. Aramberri-Gutiérrez M, Martínez-Menduiña A, Valencia-Mora M, Boyle S. All-suture transosseous repair for rotator cuff tear fixation using medial calcar fixation. Arthrosc Tech. 2015; 4(2): e169-73.
• 16. Arican M, Turhan Y, Karaduman ZO, Ayanoğlu T. Clinical and functional outcomes of a novel transosseous device to treat rotator cuff tears: a minimum 2-year follow-up. J Orthop Surg (Hong Kong). 2019; 27(3): 1-10. doi:10.1177/2309499019875172.
• 17. Nho SJ, Shindle MK, Sherman SL, Freedman KB. Systematic review of arthroscopic rotator cuff repair and mini-open rotator cuffrepair. JBJS. 2007; 89(Suppl 3): 127-36.
• 18. Bond EC, Hunt L, Brick MJ, Leigh WB, Maher A, Young SW, et al. Arthroscopic, open and mini-open approach for rotator cuff repair: no difference in pain or function at 24 months. ANZ J Surg. 2018; 88(1-2): 50-5.
• 19. Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL. Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg. 2006; 15(3): 290-9.
• 20. Behrens SB, Bruce B, Zonno AJ, Paller D, Green A. Initial fixation strength of transosseous-equivalent suture bridge rotator cuff repair is comparable with transosseous repair. Am J Sports Med. 2012; 40(1): 133-40.
• 21. Pellegrini A, Lunini E, Rebuzzi M, Verdano M, Baudi P, Ceccarelli F. Arthroscopic rotator cuff tear transosseous repair system: the sharc-ft using the taylor stitcher. Arthrosc Tech. 2015; 4(3): e201-5.
• 22. Kilcoyne KG, Guillaume SG, Hannan CV, Langdale ER, Belkoff SM, Srikumaran U. Anchored transosseous-equivalent versus anchor¬less transosseous rotator cuff repair: a biomechanical analysis in a cadaveric model. Am J Sports Med. 2017; 45(10): 2364-71.
• 23. Kummer FJ, Hahn M, Day M, Meislin RJ, Jazrawi LM. A labora¬tory comparison of a new arthroscopic transosseous rotator cuff repair to a double row transosseous equivalent rotator cuff repair using suture anchors. Bull Hosp Jt Dis. 2013; 71(2): 128-31.
• 24. Flanagin BA, Garofalo R, Lo EY, Feher LA, Castagna A, Qin H, et al. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair. Int J Shoulder Surg. 2016; 10(1): 3-9.
• 25. Randelli P, Stoppani CA, Zaolino C, Menon A, Randelli F, Cabitza P. Advantages of arthroscopic aotator cuff repair with a transosseous suture technique: a prospective randomized controlled. Am J Sports Med. 2017; 45(9): 2000-9.
• 26. Dyrna F, Voss A, Pauzenberger L, Obopilwe E, Mazzocca AD, Castagna A, et al. Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery. BMC Musculoskelet Disord. 2018; 19(1): 240.
• 27. Mantovani M, Baudi P, Paladini P, Pellegrini A, Verdano MA, Porcellini G, et al. Gap formation in a transosseous rotator cuff repair as a function of bone quality. Clin Biomech (Bristol, Avon). 2014; 29(4): 429-33.
• 28. Wu X, Briggs L, Murrell GA. Intraoperative determinants of rota¬tor cuff repair integrity an analysis of 500 consecutive repairs. Am J Sports Med. 2012; 40(12): 2771-6.
• 29. Kaar TK, Schenck RC Jr, Wirth MA, Rockwood CA Jr. Complications of metallic suture anchors in shoulder surgery: a report of 8 cases. Arthroscopy. 2001; 17(1): 31-7. 30. Djurasovic M, Marra G, Arroyo JS, Pollock RG, Flatow EL, Bigliani LU. Revision rotator cuff repair: factors influencing results. J Bone Joint Surg Am. 2001; 83(12): 1849-55.
• 31. Benson EC, MacDermid JC, Drosdowech DS, Athwal GS. The incidence of early metallic suture anchor pullout after arthroscopic rotator cuff repair. Arthroscopy. 2010; 26(3): 310-5.
• 32. Bicanic G, Cicak N, Trsek D, Klobucar H. Letter to the editor: advantages of arthroscopic transosseous suture repair of the rotator cuff without the use of anchors. Clin Orthop Relat Res. 2014; 472(3): 1043.
• 33. Black EM, Lin A, Srikumaran U, Jain N, Freehill MT. Arthroscopic transosseous rotator cuff repair: technical note, outcomes, and complications. Orthopedics. 2015; 38(5): e352-8.