Rotator Manşet Tedavisi Sırasında Biseps Uzun Başı Patolojilerinin Tedavisinde Artroskopik Tenodez Ve Tenotominin Sonuçlarının Karşılaştırılması

Yıl 2021, , 195 - 201, 30.08.2021

Mustafa Özçamdallı , Gökay Eken , Mahmut Günay , Mehmet Yetiş , Turan Bilge Kızkapan

https://doi.org/10.30565/medalanya.783683

Öz

Amaç: Tam kat rotator manşet yırtıkları sıklıkla biseps uzun başı tenonu patolojileri ile birlikte görülmektedir. Bu çalışmanın amacı artroskopik rotator manşet tamiri yapılan ve ek olarak biseps uzun başı tendon patolojisi nedeniyle tenodez ve tenotomi tedavisi yapılan hastaların klinik skor, komplikasyon oranı ve işe dönüş oran ve zamanlarını karşılaştırmaktır.

Yöntemler: 129 artroskopik rotator manşet onarımı yapılan hasta 2 gruba ayrıldı. 1. Grupta biseps tenodezi uygulanan 62 hasta, 2. Grupta biseps tenotomisi uygulanan 67 hasta bulunmakta idi. Demografik ve klinik bulgular, komplikasyonlar, American Shoulder and Elbow Surgeons (ASES), Constant Murley (CM), Visual analogue scale (VAS) ve 36-item Short Form (SF-36) alt skorları değerlendirildi.

Bulgular: Ortalama takip süresi 13.68±4.22 ay idi. Ortalama ASES, CM, VAS ve SF-36 skorlarına bakıldığında gruplar arasında postoperatif ve preoperatif-postoperatif fark değerlerinde anlamlı fark bulunamadı. Popeye bulgusu 2. Grupta 13 (%19,4) hastada pozitif iken 1. Grupta hiçbir hastada görülmedi (p<0.001). Diğer kompikasyon oranlarında gruplar arasında anlamlı fark saptanmadı.

Sonuç: Artroskopik rotator manşet tamiri yapılan hastalarda, biseps tenodezi ve tenotomisi bisep uzun baş patolojilerinde klinik olarak iyi sonuç veren tedavi metodlarıdır. Teknik olarak daha zor ve maliyetli tenodez yerine tenotominin güvenle tercih edilebileceğini düşünmekteyiz.

Anahtar Kelimeler

Biseps tendonu, tenotomi, tenodez, omuz artroskopisi

Comparing the outcomes of arthroscopic tenodesis versus tenotomy for the treatment of the long head of biceps tendon pathologies during supraspinatus tendon repair

Öz

Aim: Long head of the biceps tendon pathologies are frequently accompany full-thickness rotator cuff tear. The purpose of this study was to compare functional scores, complication rates, and time to return to work after tenotomy and tenodesis who underwent arthroscopic supraspinatus repair (ASR).

Methods: Overall, 129 patients who underwent ASR surgery were divided into 2 groups. Group 1 consists of 62 patients underwent biceps tenodesis and group 2 consists of 67 patients underwent biceps tenotomy. We evaluated demographic data, clinical findings, complications and American Shoulder and Elbow Surgeons, Constant Murley, Visual analogue scale and 36-item Short Form subscale scores.

Results: Mean follow-up time was 13.68±4.22 months. Mean postoperative and preoperative-postoperative differences of ASES, CM, VAS and SF-36 subscale scores were not significantly different between two groups. Popeye sign was positive for 13 (19.4%) patients in group 2, however, none of patients in group 1 was positive (p<0.001). Other complications were not significantly different between two groups.

Conclusion: The results show that arthroscopic biceps tenotomy and tenodesis are both viable treatments for proximal biceps tendon pathology, yielding similar clinical outcomes in the context of concomitant rotator cuff repair. Tenotomy can be chosen instead of tenodesis which is technically more difficult and expensive.

Anahtar Kelimeler

tenodesis,, shoulder arthroscopy,, tenotomy,, biceps tendon,

Kaynakça

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