Rotator Manşet Yırtıklarında Artroskopik Yardımlı Mini Açık ve Artroskopik Tamir Yöntemlerinin Klinik ve Radyolojik Sonuçlarının Karşılaştırılması

Abstract

SONUÇ: Rotator manşet yırtığının tedavinde hem artroskopi yardimlı mini açık ve hem de artroskopi, klinik ve radyolojik olarak başarılı sonuçlar vermektedir. Yöntemlerin arasinda ağrı, fonksiyon kapasitesi, hareket açıklığı, kuvvet skorları ve memnuniyet arasından anlamlı bir fark bulunmadi. Sonuçlar her iki yöntemin, ilgili ortopedistler için uygun olabilecegini göstermektedir. 

Group 1 ve 2 nin kiyaslamasinda UCLA p=0,94, Constant p= 0,356 bulundu.  Iki grubun fizik muayene, radyolojik ve subjektif verileri arasinda anlamlı bir farklılık bulunmadi.

Cerrahi sonrası fizik muayene, radyolojik ve subjektif verilerinde her iki grupta ameliyat öncesine göre belirgin olarak iyileşme gösterdiği görüldü (p<0,0001).

Radyolojik Thomazeau atrofi ve yağlı dejenerasyon sınıflamasında, 11 grade 1, 25 grade 2, 4 grade 3 idi. Tendon bütünlüğü sağlam olarak değerlendirilen hastalarda yağlı dejenerasyon ve atrofide artma izlenmedi, yırtık olan 6 hastanın 3’ünde seviye artış gözlendi.

Grup 2’ de, ortalama yaşı 53,1 idi. UCLA skorlaması ameliyat öncesi ortalama 11,12 sonrası 31,16. Constant Murley skorlaması ameliyat öncesi ortalama 31, sonrası 87,48 idi.

BULGULAR: Grup 1’de, ortalama yaş 57,4 idi.  UCLA skorlaması ameliyat öncesi ortalama 10,93, sonrası 32,46 idi. Constant Murley skorlaması ameliyat öncesi ortalama 31,6 sonrası 88,13 idi. 

GEREÇ VE YÖNTEMLER: 2014-2016 yılları arasında 40 hasta 2 grup halinde retrospektif olarak incelendi. 15 atroskopi yardımlı mini açık (grup 1), 25 artroskopik yöntemle (grup 2) tedavi edildi. Gruplar, yaş, cinsiyet, cerrahi öncesi ve sonrası muayene ve radyolojik bulgular, Constant Murley ve UCLA skorlamaları açısından değerlendirildi.

AMAÇ: Rotator manşet yırtıklarının tamirinde uygulanan artroskopi yardımlı mini açık ve artroskopik yöntemlerinin klinik ve radyolojik olarak karşılaştırılması amaclanmistir.

Keywords

• Rotator Manşon Rüptürü;,Artroskopik cerrahi;,Omuz;,Tamir

Clinical and Radiology Comparison of Arthroscopy-Aided Mini Open and Arthroscopic Repair Methods for Rotator Cuff Tears

Abstract

OBJECTIVE: We aimed clinical and radiologic comparison of arthroscopy assisted mini open and arthroscopic repair methods for rotator cuff tears.

MATERIALS AND METHODS: Forty patients between 2014 and 2016 were retrospectively reviewed; divided into 2 groups; 15 patients (group 1- mini open) and 25 (group 2 - arthroscopic). Age, gender, surgical intervention, pre and post surgical examination findings, Constant Murley, UCLA scores, radiological findings were evaluated.

RESULTS: Mean age was 57.4 for group 1 and 53.1 for group 2. Mean UCLA score improved to 32.46 postoperatively from 10.93 for group 1 and to 1.12 from 31.16 postoperatvely for group 2. Mean Constant Murley score improved to 88.13 postoperatively from 31,6 for group 1 and to 87.48 postoperatively from 31 for group 2.

Radiological classification by Thomazeau showed 11 patients grade 1, 25 grade 2 and 4 grade 3. There was no increase in fatty degeneration in patients with intact tendon, but increase in 3 with tears.

Postoperative physical examination, radiological and subjective evaluation showed significant improvement in both groups (p <0,0001).

In comparison of groups, p was 0.356 for UCLA and 0.94 for Constant Murley.  There was no significant difference for physical examination, radiological and subjective data between groups.

CONCLUSION: Both arthroscopy assisted mini-open and arthroscopic methods were clinically and radiologically successful for rotator cuff repair There was no significant difference in pain, functional capacity, range of motion, strength scores and satisfaction rates between groups. These results suggest that both approaches may be appropriate for orthopedists with necessary experience.

Keywords

• Rotator cuff tears;,Arthroscopic Surgery;,Shoulder;,Repair

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