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

Yıl 2018, Cilt: 8 Sayı: 4, 788 - 797, 30.12.2018
https://doi.org/10.31832/smj.434096

Öz

SONUÇ: Rotator manşet yırtığının tedavinde hem
artroskopi yard
imlı
mini açık ve hem de artroskopi
, klinik
ve radyolojik olarak başarılı sonu
çlar
vermektedir.
Yöntemlerin arasinda ağrı, fonksiyon kapasitesi,
hareket açıklığı, kuvvet skorları ve memnuniyet arasında
n anlamlı bir fark bulunmadi. Sonuçlar
her iki y
öntemin, ilgili ortopedistler için uygun olabilecegini göstermektedir. 



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



Cerrahi sonrası fizik muayene, radyolojik
ve subjektif verilerinde her iki grupta ameliyat
öncesine göre
belirgin olarak iyileşme g
österdiği görül (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 atrofi
de artma izlenmedi, yırtık olan 6
hastan
ın
3’ünde seviye artış g
özlendi.



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 y
öntemle (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.

Kaynakça

  • 1. Mantone JK, Burkhead WZ Jr, Noonan J Jr. Nonoperative treatment of rotator cuff tears. In: Friedman RJ, editor. The Orthopedic Clinics of North America, Conservative Management of Shoul-der Injuries. Philadelphia: W. B. Saunders;. p. 295- 311 Audenaert E, VanNuffel J, Schepens A, Ver-helst M, Verdonk R. (2006) Reconstruction of massive rotator cuff lesions with a synthetic interposi-tion graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc 2000;14: 360-364
  • 2. Audenaert E, VanNuffel J, Schepens A, Verhelst M, Verdonk R. Reconstruction of massive rota-tor cuff lesions with a synthetic interposition graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc 2006;14: 360-364
  • 3. Akgün I, Kesmezacar H. Arthroscopy of the shoulder: general principles and stages for promot-ing competence. Acta Orthopaedica Et Traumatologica Turcica 2003; 37 Suppl 1: 54-68
  • 4. Demirhan, MT, Atalar, AT, Kocabey, YT, & Akalın, YT. Rotator manşet yırtıklarının artroskopik yardımlı mini-açık yöntemle tamiri. Acta Orthopaedica Et Traumatologica Turcica 2002; 36(1), 1
  • 5. Levy HJ, Uribe JW, Delaney LG. Arthroscopic assisted rotator cuff repair: preliminary results. Ar-throscopy 1990; 6: 5 5 - 6 0.
  • 6. Henry P, Wasserstein D, Park S, Dwyer T, Chahal J, Slobogean G, & Schemitsch E. (2015). Sys-tematic Review: Arthroscopic Repair for Chronic Massive Rotator Cuff Tears: A Systematic Review. Arthroscopy: The Journal Of Arthroscopic And Related Surgery 2015; (31) 2472-2480
  • 7. Verma NN, Dunn W, Adler RS, Cordasco FA, Allen A, MacGillivray J, Craig E, Warren RF, and David W. Altchek DW. All-Arthroscopic Versus Mini-Open Rotator Cuff Repair: A Retrospective Re-view With Minimum 2-Year Follow-up. Arthroscopy: The Journal of Arthroscopic and Related Sur-gery 2006; Vol 22, No 6 (June), pp 587-594
  • 8. Huang, R, Wang, S, Wang, Y, Qin, X, & Sun, Y. 'Systematic Review of All-Arthroscopic Versus Mini-Open Repair of Rotator Cuff Tears: A Meta-Analysis', Scientific Reports 2016, vol. 6.
  • 9. Nicholson GDM. Mini-open rotator cuff repair for supraspi- natus tears. Presented at: Second Bi-ennial Shoulder and Elbow Meeting, 2000, Miami, Florida.
  • 10. Weber SC. All-arthroscopic versus mini-open repair in the management of tears of the rotator cuff: A prospective evalu- ation. Presented at: Arthroscopy Association Annual Meeting, 2003, Or-lando, Florida.
  • 11. Wolf EM, Pennington W, Agrawal V. Arthroscopic rotator cuff repair: 4-10 year results. Arthros-copy 2004;20:5-12.
  • 12. Demirhan M, Akman Ş, Akalın Y. Omuz eklemi hastalıklarında preoperatif ve postoperatif skor-lama. Acta Orthop Traumatol Turc 1993; 27:129-131
  • 13. Habermeyer P, Magosch P, Lichtenberg S. Classicifations and Scores of the Shoulder, Spring 2006; Berlin 14. Liu SH. Arthroscopically-assisted rotator-cuff repair. J Bone Joint Surg Br. 1994; 76(4):592-5. 15. Boszotta H, Prünner K. Arthroscopically assisted rotator cuff repair. Arthroscopy: The Journal Of Arthroscopic And Related Surgery. 2004; 20:620-626
  • 16. Jones CK, Savoie FH. Arthroscopic repair of large and massive rotator cuff tears. Arthroscopy. 2003;19:564-71.
  • 17. Kumar, R, & Jadhav, U. 'Functional evaluation of patient after arthroscopic repair of rotator cuff tear', Journal of Clinical Orthopaedics And Trauma 2014; no 2, p. 84
  • 18. Fink Barnes LA, Kim HM, Caldwell JM, Buza J, Ahmad C S, Bigliani LU, Levine WN. Satisfaction, function and repair integrity after arthroscopic versus mini-open rotator cuff repair. Bone Joint J 2017;99-B:245–9.
  • 19. Zhang Z, Gu B, Zhu W, Zhu L & Li Q. Arthroscopic versus mini open rotator cuf repair: a pro-spective, randomized study with 24-month follow-up. European Journal of Orthopaedic Surgery & Traumatology 2014; 24, 845–850
  • 20. Knudsen HB, Gelineck J, Sojbjerg JO, Olsen BS, Johannsen HV, Sneppen O.Functional and magnetic resonance imaging evaluation after single-tendon rotator cuff reconstruction. J Shoulder Elbow Surg 1999;8:242-6
  • 21. Chung SW, Huong CB, Kim SH & Oh JH. Shoulder stiffess after rotator cuf repair: risk factors and inflence on outcome.Arthroscopy: Th Journal of Arthroscopic & Related Surgery 2013; 29, 290–300.
  • 22. Jung GH, Lee YK, & Shin HK. Early postoperative outcomes between arthroscopic and mini-open repair for rotator cuf tears. Orthopedics (Online) 2012; 35, e1347.
  • 23. Severud EL, Ruotolo C, Abbott DD & Nottage WM. All-arthroscopic versus mini-open rotator cuf repair: a long-term retrospective outcome comparison. Arthroscopy: Th Journal of Arthroscopic & Related Surgery 2003; 19, 234–238.
  • 24. Köse, K. Ç. et al. Mini-open versus all-arthroscopic rotator cuf repair: comparison of the opera-tive costs and the clinical outcomes. Advances in therapy 2008; 25, 249
  • 25. Pearsall AW, Ibrahim KA, & Madanagopal S G. The results of arthroscopic versus mini-open re-pair for rotator cuf tears at mid-term follow-up. Journal of orthopaedic surgery and research 2007; 2, 24.
  • 26. Liem D, Lichtenberg S, Magosch P, & Habermeyer P. Magnetic Resonance Imaging of Arthro-scopic Supraspinatus Tendon Repair. Journal Of Bone & Joint Surgery, American Volume, 2007; 89(8), 1770-1776.

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

Yıl 2018, Cilt: 8 Sayı: 4, 788 - 797, 30.12.2018
https://doi.org/10.31832/smj.434096

Öz



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.




Kaynakça

  • 1. Mantone JK, Burkhead WZ Jr, Noonan J Jr. Nonoperative treatment of rotator cuff tears. In: Friedman RJ, editor. The Orthopedic Clinics of North America, Conservative Management of Shoul-der Injuries. Philadelphia: W. B. Saunders;. p. 295- 311 Audenaert E, VanNuffel J, Schepens A, Ver-helst M, Verdonk R. (2006) Reconstruction of massive rotator cuff lesions with a synthetic interposi-tion graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc 2000;14: 360-364
  • 2. Audenaert E, VanNuffel J, Schepens A, Verhelst M, Verdonk R. Reconstruction of massive rota-tor cuff lesions with a synthetic interposition graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc 2006;14: 360-364
  • 3. Akgün I, Kesmezacar H. Arthroscopy of the shoulder: general principles and stages for promot-ing competence. Acta Orthopaedica Et Traumatologica Turcica 2003; 37 Suppl 1: 54-68
  • 4. Demirhan, MT, Atalar, AT, Kocabey, YT, & Akalın, YT. Rotator manşet yırtıklarının artroskopik yardımlı mini-açık yöntemle tamiri. Acta Orthopaedica Et Traumatologica Turcica 2002; 36(1), 1
  • 5. Levy HJ, Uribe JW, Delaney LG. Arthroscopic assisted rotator cuff repair: preliminary results. Ar-throscopy 1990; 6: 5 5 - 6 0.
  • 6. Henry P, Wasserstein D, Park S, Dwyer T, Chahal J, Slobogean G, & Schemitsch E. (2015). Sys-tematic Review: Arthroscopic Repair for Chronic Massive Rotator Cuff Tears: A Systematic Review. Arthroscopy: The Journal Of Arthroscopic And Related Surgery 2015; (31) 2472-2480
  • 7. Verma NN, Dunn W, Adler RS, Cordasco FA, Allen A, MacGillivray J, Craig E, Warren RF, and David W. Altchek DW. All-Arthroscopic Versus Mini-Open Rotator Cuff Repair: A Retrospective Re-view With Minimum 2-Year Follow-up. Arthroscopy: The Journal of Arthroscopic and Related Sur-gery 2006; Vol 22, No 6 (June), pp 587-594
  • 8. Huang, R, Wang, S, Wang, Y, Qin, X, & Sun, Y. 'Systematic Review of All-Arthroscopic Versus Mini-Open Repair of Rotator Cuff Tears: A Meta-Analysis', Scientific Reports 2016, vol. 6.
  • 9. Nicholson GDM. Mini-open rotator cuff repair for supraspi- natus tears. Presented at: Second Bi-ennial Shoulder and Elbow Meeting, 2000, Miami, Florida.
  • 10. Weber SC. All-arthroscopic versus mini-open repair in the management of tears of the rotator cuff: A prospective evalu- ation. Presented at: Arthroscopy Association Annual Meeting, 2003, Or-lando, Florida.
  • 11. Wolf EM, Pennington W, Agrawal V. Arthroscopic rotator cuff repair: 4-10 year results. Arthros-copy 2004;20:5-12.
  • 12. Demirhan M, Akman Ş, Akalın Y. Omuz eklemi hastalıklarında preoperatif ve postoperatif skor-lama. Acta Orthop Traumatol Turc 1993; 27:129-131
  • 13. Habermeyer P, Magosch P, Lichtenberg S. Classicifations and Scores of the Shoulder, Spring 2006; Berlin 14. Liu SH. Arthroscopically-assisted rotator-cuff repair. J Bone Joint Surg Br. 1994; 76(4):592-5. 15. Boszotta H, Prünner K. Arthroscopically assisted rotator cuff repair. Arthroscopy: The Journal Of Arthroscopic And Related Surgery. 2004; 20:620-626
  • 16. Jones CK, Savoie FH. Arthroscopic repair of large and massive rotator cuff tears. Arthroscopy. 2003;19:564-71.
  • 17. Kumar, R, & Jadhav, U. 'Functional evaluation of patient after arthroscopic repair of rotator cuff tear', Journal of Clinical Orthopaedics And Trauma 2014; no 2, p. 84
  • 18. Fink Barnes LA, Kim HM, Caldwell JM, Buza J, Ahmad C S, Bigliani LU, Levine WN. Satisfaction, function and repair integrity after arthroscopic versus mini-open rotator cuff repair. Bone Joint J 2017;99-B:245–9.
  • 19. Zhang Z, Gu B, Zhu W, Zhu L & Li Q. Arthroscopic versus mini open rotator cuf repair: a pro-spective, randomized study with 24-month follow-up. European Journal of Orthopaedic Surgery & Traumatology 2014; 24, 845–850
  • 20. Knudsen HB, Gelineck J, Sojbjerg JO, Olsen BS, Johannsen HV, Sneppen O.Functional and magnetic resonance imaging evaluation after single-tendon rotator cuff reconstruction. J Shoulder Elbow Surg 1999;8:242-6
  • 21. Chung SW, Huong CB, Kim SH & Oh JH. Shoulder stiffess after rotator cuf repair: risk factors and inflence on outcome.Arthroscopy: Th Journal of Arthroscopic & Related Surgery 2013; 29, 290–300.
  • 22. Jung GH, Lee YK, & Shin HK. Early postoperative outcomes between arthroscopic and mini-open repair for rotator cuf tears. Orthopedics (Online) 2012; 35, e1347.
  • 23. Severud EL, Ruotolo C, Abbott DD & Nottage WM. All-arthroscopic versus mini-open rotator cuf repair: a long-term retrospective outcome comparison. Arthroscopy: Th Journal of Arthroscopic & Related Surgery 2003; 19, 234–238.
  • 24. Köse, K. Ç. et al. Mini-open versus all-arthroscopic rotator cuf repair: comparison of the opera-tive costs and the clinical outcomes. Advances in therapy 2008; 25, 249
  • 25. Pearsall AW, Ibrahim KA, & Madanagopal S G. The results of arthroscopic versus mini-open re-pair for rotator cuf tears at mid-term follow-up. Journal of orthopaedic surgery and research 2007; 2, 24.
  • 26. Liem D, Lichtenberg S, Magosch P, & Habermeyer P. Magnetic Resonance Imaging of Arthro-scopic Supraspinatus Tendon Repair. Journal Of Bone & Joint Surgery, American Volume, 2007; 89(8), 1770-1776.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Levent Bayam

Eren Kıran Bu kişi benim

Mehmet Erdem Bu kişi benim

Alauddin Kochai

Mehmet Türker

Yayımlanma Tarihi 30 Aralık 2018
Gönderilme Tarihi 14 Haziran 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 8 Sayı: 4

Kaynak Göster

AMA Bayam L, Kıran E, Erdem M, Kochai A, Türker M. Rotator Manşet Yırtıklarında Artroskopik Yardımlı Mini Açık ve Artroskopik Tamir Yöntemlerinin Klinik ve Radyolojik Sonuçlarının Karşılaştırılması. Sakarya Tıp Dergisi. Aralık 2018;8(4):788-797. doi:10.31832/smj.434096

30703

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