Mehmet Uğur ÖZBAYDAR, Çağrı TEKİN, Rıfat KOCABAŞ, MEHMET ALTUN

Superior labrum anterior posterior ve Bankart kombine lezyonlarının artroskopik tamiri

Amaç: Superior labrum anterior posterior (SLAP) lezyonuyla birlikte antero-inferior labral ayrışma (Bankart lezyonu) bulunan (Maffet, tip 5) ve artroskopik olarak tamir edilen olgular geriye dönük olarak değerlendirildi. Çalışma planı: Tip 5 SLAP lezyonu nedeniyle dikişli çapalarla tamir edilen sekiz erkek hasta (ort. yaş 31.8; dağılım 23-50) çalışmaya alındı. Tüm hastalarda yakınmalar travma sonrası başlamıştı ve öne omuz instabilitesi bulguları vardı. Hastaların hareket açıklığı oturur pozisyonda açı ölçerle ölçüldü, kas kuvvetleri manuel olarak değerlendirildi; ayrıca, Speed testi, O’Brien testi ve Jobe relokasyon testi uygulandı. Tüm hastalara standart omuz manyetik rezonans görüntüleme incelemesi yapıldı. Fonksiyonel sonuçlar UCLA (University of California at Los Angeles) omuz değerlendirme formu ve Rowe Bankart tamiri için skorlama tablosuyla değerlendirildi. Ameliyat sonrası takip süresi ortalama 37.8 ay (dağılım 24-52 ay) idi. Sonuçlar: Beş hastada iyi-çok iyi, ikisinde orta sonuç elde edilirken, birinde sonuç kötü bulundu. UCLA skoru ameliyat öncesi dönemde ortalama 15 (dağılım 14-17) iken, son kontrollerde 30 (dağılım 20-35) bulundu (p

Anahtar Kelimeler:

Tendon yaralanmaları, Tedavi sonucu, İnternal fiksatörler, Artroskopi, Eklem instabilitesi, Geriyedönük çalışma, Omuz çıkığı, Hareket açıklığı, eklem

Arthroscopic repair of combined superior labrum anterior posterior and Bankart lesions

Objectives: We retrospectively evaluated patients who underwent arthroscopic treatment for superior labrum anterior posterior (SLAP) lesions combined with antero-inferior labral detachment (Bankart lesion, Maffet, type 5). Methods: The study included eight male patients (mean age 31.8 years; range 23 to 50 years) who were treated with suture anchors for type 5 SLAP lesions. In all the patients the symptoms started after trauma, and all presented with shoulder instability findings. The range of motion was measured in the sitting position by a goniometer, and muscle force was assessed manually. In addition, Speed and O’Brien tests and Jobe relocation test were performed. All the patients were examined by standard shoulder magnetic resonance scans. Functional results were evaluated according to the UCLA (University of California at Los Angeles) shoulder score, and the Rowe rating scale for Bankart repairs. The mean follow-up was 37.8 months (range 24-52 months). Results: Functional results were excellent-good in five patients, fair in two patients, and poor in one patient. The mean UCLA score increased from a preoperative 15 (range 14-17) to a postoperative 30 (range 20-35), with a corresponding increase in the mean Rowe score from 25 (range 15-45) to 81 (range 50-95) (p<0.05). Conclusion: Arthroscopic repair of combined Bankart and SLAP lesions may present technical difficulties. Nevertheless, it is possible to get good results in selected patients in whom intraarticular pathologies are diagnosed and treated appropriately.

Keywords:

Tendon Injuries, Treatment Outcome, Internal Fixators, Arthroscopy, Joint Instability, Retrospective Studies, Shoulder Dislocation, Range of Motion, Articular,

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