Meriç UĞURLAR, Mesut Mehmet SÖNMEZ, Özge Yapıcı UĞURLAR, Abdulkadir SARI, Osman Tuğrul EREN

Tam Kat Rotator Manşet Yırtıklarında Artroskopik Yardımlı Onarım: 5 Yıllık Takipte Fonksiyonel ve Radyolojik Sonuçlar

Amaç: Çalışmamızda geniş ve masif olan tam kat rotator manşet yırtığı tanısı ile artroskopik yardımlı mini-açık rotator manşet tamiri yapılan hastaların ameliyattan sonra ortalama 5 yıllık klinik ve radyolojik sonuçları ve manyetik rezonans görüntüleme ile tekrarlayan yırtık gelişme oranları değerlendirildi. Yöntemler: Kliniğimizde geniş ve masif tam kat rotator manşet yırtığı tanısı ile konservatif tedaviye yanıt alınamayarak artroskopik yardımlı mini-açık rotator manşet tamiri uygulanan 38 hasta ameliyat öncesi ve sonrası klinik ve radyolojik olarak değerlendirildi.Bulgular: Hastaların ameliyat sonrası takip süreleri 60.4 aydı. UCLA skorlamasına göre 26 hastada mükemmel, 10 hastada iyi ve 2 hastada ise orta derecede sonuç mevcuttu. Constant skorlamasına göre 24 hastada mükemmel, 12 hastada iyi ve 2 hastada ise orta derecede sonuç mevcuttu. 38 hastanın 34'ü sonuçtan memnun olduğunu belirttiler. Hastaların son takiplerinde çekilen omuz MRG'lerinde rotator manşet devamlılığı değerlendirildi ve 8 hastada tekrarlayan yırtık olduğu görüldü.Sonuç: Hastaların yaşına bağlı olarak tekrarlayan yırtık oranları değişmekle birlikte ileri yaşlı hastalarda orta derece klinik sonuçlar elde edilmektedir. Buna rağmen tam kat, geniş ve masif yırtıkların tedavisinde tekrarlayan yırtık oranlarına rağmen artroskopik yardımlı mini-açık rotator manşet tamiri ile tatminkar klinik sonuçlar elde edilebilmektedir.

Arthroscopic-Assisted Repair in Full-Thickness Rotator Cuff Ruptures: Functional and Radiologic Results of Five-Year Follow-Up

Objective: In our study, we evaluated the post-operative 5-year clinical and radiological results and the ratio of recurrent ruptures under magnetic resonance imaging of the patients diagnosed as wide and massive, full-thickness rotator cuff rupture and arthroscopic-assisted miniopen rotator cuff repair is applied.Methods: We evaluated the pre-operative and post-operative clinical and radiological results of 38 patients with wide and massive, full-thickness rotator cuff rupture and arthroscopic-assisted rotator cuff repair is applied after failure of conservative treatment.Results: Mean post-operative follow-up period was 60.4 months. According to UCLA scoring there were excellent results in 26 patients, good results in 10, and moderate results in 2 patients. According to Constant scoring there were excellent results in 24 patients, good results in 12, and moderate results in 2 patients. 34 of the 38 patients indicated that they were satisfied with the results. The continuity of the rotator cuffs are evaluated with magnetic resonance imaging at the last visits of the patients and there was recurrent ruptures at the 8 patients.Conclusion: Although recurrent rotator cuff rupture rates varies depending on the age of the patients, moderate clinical results are obtained in elder patients. Nevertheless, despite the rupture rates in the treatment of wide and massive, full-thickness ruptures, satisfactory clinical results can be obtained with arthroscopic-assisted miniopen rotator cuff repair.

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