Mehmet Uğur ÖZBAYDAR, Taner BEKMEZCİ, Murat TONBUL, Cihangir YURDOĞLU

Rotator manşetin kısmi yırtıklarında artroskopik tedavi sonuçları

Amaç: Rotator manşette tendon kalınlığının %50’sinden daha az kısmi yırtık bulunan hastalarda uygulanan artroskopik tedavi sonrasında yırtığın seyri ve bunun hastalara etkisi değerlendirildi. Çalışma planı: Çalışmaya, kısmi rotator manşet yırtığı nedeniyle uygulanan konservatif tedaviye yanıt vermeyen ve artroskopik tamir veya birlikte subakromiyal dekompresyon uygulanan 19 hasta (10 kadın, 9 erkek; ort. yaş 49; dağılım 40-70) alındı. On iki hastada yakınmalar belirgin bir travma sonrası başlamıştı. Yakınmaların süresi ortalama 12 ay (dağılım 7-24 ay) idi. Kısmi yırtık 12 hastada artiküler, yedi hastada ise bursal yüzdeydi. Hastalar ameliyat öncesi ve sonrasında fizik muayene, manyetik rezonans görüntüleme (MRG) ve UCLA skoru ile değerlendirildi. Ameliyattan sonra ortalama takip süresi 29 ay (dağı- lım 12-63 ay) idi. Sonuçlar: Ameliyat öncesinde 16.8 (dağılım 10-20) olan UCLA skoru ortalaması ameliyat sonrasında 29.0 (dağı- lım 9-35) bulundu (p

Anahtar Kelimeler:

Artroskopi, Debridman, Manyetik rezonans görüntüleme, Tendon yaralanmaları, Tedavi sonucu, Akromiyon, Yırtık, Yara iyileşmesi, Rotator manşet

The results of arthroscopic repair in parital rotator cuff tears

Objectives: We evaluated patients who underwent arthroscopic repair for partial rotator cuff tears less than 50% of tendon thickness with respect to the course of tears and functional results. Methods: Nineteen patients (10 women, 9 men; mean age 49 years; range 40 to 70 years) who did not benefit from conservative treatment for partial rotator cuff tears were treated with arthroscopic debridement with or without subacromial decompression. Twelve patients had a history of trauma before the appearance of complaints which had a mean duration of 12 months (range 7 to 24 months) before arthroscopic repair. Partial tears were on the articular side in 12 patients, and on the bursal side in seven patients. The patients were assessed with preoperative and postoperative physical examination, magnetic resonance imaging (MRI), and UCLA scores. Results: The mean preoperative and postoperative UCLA scores were 16.8 (range 10 to 20) and 29.0 (range 9 to 35), respectively (p<0.05). The results were excellent or good in 14 patients (73.7%), fair in two patients (10.5%), and poor in three patients (15.8). One patient developed shoulder stiffness which improved following rehabilitation. Postoperative MRI showed persistence of partial tears in 13 patients, progression in five patients, and development of total rupture in one patient. Complaints of pain increased in severity in patients in whom partial tears manifested a progressive course. One patient with total rupture underwent mini-open rotator cuff repair in the postoperative sixth month. Conclusion: Although clinical symptoms show improvement in most of the patients following arthroscopic treatment, partial rotator cuff tears do not heal completely in a considerable number of cases, and may progress to fullthickness tears in some.

Keywords:

Arthroscopy, Debridement, Magnetic Resonance Imaging, Tendon Injuries, Treatment Outcome, Acromion, Rupture, Wound Healing, Rotator Cuff,

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