Kronik rotator manşet yırtığı olan hastaların tedavisinde basit çift-sıra rotator manşet tamiri ile "Belt and Suspender’s" tekniğinin karşılaştırılması

Amaç: Kronik rotator manşet yırtıklarının tedavisi henüz açıklığa kavuşmamıştır. Birçok cerrahi teknik kullanılagelmiştir. Bu çalışmanın amacı farklı iki cerrahi tekniğin fonksiyonel sonuçlarının karşılaştırılmasıdır.Yöntem: 27 hastanın 13'üne (2 erkek, 11 kadın) Belt and Suspenders tekniği, 14 'üne (4 erkek, 10 kadın) klasik çift-sıra tekniği ile rotator manşet tamiri uygulanmıştır. Klinik değerlendirme American Shoulder and Elbow Surgeons (ASES) skorlama sistemi ve ve Görsel Analog Skala (VAS) kullanılarak yapılmıştır.Bulgular: Ameliyat sonrası dönem ASES ve VAS skorları arasında, eklem hareket açıklıkları arasında ve komplikasyonlar bakımından anlamlı farklılık görülmedi. Her iki grupta da birer hastada iyileşme de yetersizlik görüldü. Sonuç: Çalışmamıza göre Belt and Suspender's tekniği en az basit çift sıra rotator manşet tamiri kadar etkili ve güvenilirdir. Ameliyat sonrası erken dönemde iyi fonksiyonel sonuçlar elde edilebilir.

Anahtar Kelimeler:

Kronik rotator manşet yırtığı, çift-sıra tamir, fonksiyonel sonuç, “Belt and Suspender’s” tekniği

Comparison of Belt and Suspender’s Technique with simple double-row rotator cuff repair in patients with chronic rotator cuff tear

Aim: Surgical treatment of chronic rotator cuff tears is still unclear. Many surgical techniques have been used in the treatment. The aim of the study is to compare the functional outcomes of two different surgical techniques.Methods: Of the 27 patients in the study; 13 underwent Belt and Suspender's Technique (2 male, 11 female), 14 underwent simple double row rotator cuff repair technique (4 male, 10 female). Clinical assessment was made according to American Shoulder and Elbow Surgeons (ASES) scoring system and Visual Analog Scale (VAS).Results: There was no statistically significant difference between postoperative ASES scores, VAS scores, range of motions (ROM) and complications. In both groups, failure of healing was seen in one each patient. Conclusion: According to this study treatment for chronic rotator cuff tear using a Belt and Suspender's technique is as effective and reliable as simple double row cuff repair technique method with low complication rates and good results can be achieved in clinical outcomes in the early postoperative period.

Keywords:

Chronic rotator cuff tear, double-row repair, functional outcome, Belt and Suspender's technique,

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1. Klein J, Whitsell B, Artemiadis PK, Buneo CA. Perception of Arm Position in Three-Dimensional Space. Front Hum Neurosci. 2018;12:331.
2. Ban I, Troelsen A, Christiansen DH, Svendsen SW, Kristensen MT. Standardised test protocol (Constant Score) for evaluation of functionality in patients with shoulder disorder. Dan Med J. 2013;60:A4608.
3. Randelli P, Cucchi D, Ragone V, de Girolamo L, Cabitza P, Randelli M. History of rotator cuff surgery. Knee Surg Sports Traumatol Arthrosc. 2015;23:344-62.
4. Randelli P, Bak K, Milano G. State of the art in rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2015;23:341.
5. Lerner M, Turkmen I, Bernd L. Formation of a physiological reverse shoulder joint. BMJ Case Rep. 2016 Jan 20;2016. doi: 10.1136/bcr-2015-213795.
6. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987:214:160-4.
7. Beauthier V, Sanghavi S, Roulot E, Hardy P. Humeral head osteonecrosis following arthroscopic rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2010;18:1432-4.
8. Tsiouri C, Mok DH. Early pullout of lateral row knotless anchor in rotator cuff repair. Int J Shoulder Surg. 2009;3:63-5. 9. Yamakado K, Katsuo S, Mizuno K, Arakawa H, Hayashi S. Medial Rotator Cuff Failure After Arthroscopic Double-Row Rotator Cuff Repair Arthroscopy. 2010;26:430-5. 10. Kim KC1, Shin HD, Cha SM, Lee WY. Comparison of Repair Integrity and Functional Outcomes for 3 Arthroscopic Suture Bridge Rotator Cuff Repair Techniques Am J Sports Med. 2013;41:271-7.
11. Boileau P, Bicknell RT, Benchikh El Fegoun A, Chuinard C. Arthroscopic Bristow-Trillat Procedure for Anterior Instability in Shoulders With a Stretched or Deficient Capsule: The “Belt-and-Suspenders” Operative Technique and Preliminary Results. In: Shoulder Concepts 2008: Arthroscopy and Arthroplasty. Boileau P, Walch G, Mole D, Favard L, Levigne C, Sirveaux F, Kempf JF (ed.) Sauramps Medical. 2008:107-18.
12. Loehr JF, Helmig P, Sojbjerg JO, Jung A. Shoulder instability caused by rotator cuff lesions. An in vitro study. Clin Orthop Relat Res. 1994;304:84-90.
13. Ozbaydar MU, Tonbul M, Yalaman O. Rotator mansetin tam kat yırtıklarında artroskopik tamir sonuçları. Acta Orthop Traumatol Turc. 2005;39:114-20.
14. Davis DL, Kesler T, Gilotra MN, Almardawi R, Hasan SA, Gullapalli RP, et al. Quantification of shoulder muscle intramuscular fatty infiltration on T1-weighted MRI: a viable alternative to the Goutallier classification system. Skeletal Radiol. 2018 Sep 10. doi: 10.1007/s00256-018-3057-7.
15. Turkmen I, Altun G. Increasing the deltoid muscle volume positively affects functional outcomes after arthroscopic rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2018 Sep 8. doi: 10.1007/s00167-018-5135-8.
16. Rhee SM, Kim DH, Kim SH, Jeong HJ, Oh JH. The Clinical Outcomes and Their Associated Factors in Staged Bilateral Arthroscopic Rotator Cuff Repair. Arthroscopy. 2018 Sep 5. doi: 10.1016/j.arthro.2018.06.026.
17. Snyder SJ, Pachelli AF, Del Pizzo W, Friedman MJ, Ferkel RD, Pattee G. Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy. 1991;7:1-7.
18. Gartsman GM. All arthroscopic rotator cuff repairs. Orthop Clin North Am. 2001;32:501-10.
19. Chalmers PN, Ross H, Granger E, Presson AP, Zhang C, Tashjian RZ. The Effect of Rotator Cuff Repair on Natural History: A Systematic Review of Intermediate to Long-Term Outcomes. JB JS Open Access. 2018;3:e0043.
20. Iagulli ND, Field LD, Hobgood ER, Ramsey JR, Savoie FH 3rd. Comparison of partial versus complete arthroscopic repair of massive rotator cuff tears. Am J Sports Med. 2012;40:1022-6.