Recep KURNAZ

9128

Rotator Manşet Yırtığı Tedavisinde Artroskopik Tek ve Çift Sıra (Transosseöz Eşdeğeri) Tamir Tekniklerinin Karşılaştırılması

Bu çalışmada rotator manşet yırtığı tanısı ile artroskopik tek sıra ve çift sıra (transosseöz eşdeğeri) tamir uygulanan hastalardaki sonuçlar karşılaştırılarak etkinlikleri değerlendirilmiştir. Mayıs 2006 ve Aralık 2011 tarihleri arasında rotator manşet yırtığı tanısı ile artroskopik tek sıra ve transosseöz eşdeğeri çift sıra tamir yapılan 71 hastanın 73 omuzu bu çalışmaya dahil edildi. Çalışmaya alınan hastaların ortalama takip süresi 33,01±17,37 (12-78) ay idi. Hastalar gruplarına göre yaş, cinsiyet, taraf, yırtık oluş sebebi, yırtık boyutu, ameliyat öncesi ve sonrası omuz hareket açıklığı, kas gücü gibi omuz muayenesinde elde edilen objektif ve subjektif bulgular ile VAS, RM-YK, ASES, Constant Murley ve UCLA gibi fonksiyonel omuz skorlarına göre karşılaştırıldı.  Ameliyat sonrası hastaların MR görüntüleri incelendiğinde, Grup 1’ de 23(%79.3) hastada tam kat iyileşme, 6(%20.7) kadar hastada da yeniden yırtık görülmüştür. Grup 2’ de ise 1(%2.3) hastada parsiyel iyileşme, 38(%86.4) hastada tam kat iyileşme, 5(%11.4) hastada da yeniden yırtık olduğu görüldü. Özellikle büyük boyutlu yırtıklarda ve yeniden yırtık oluşma ihtimalini azaltmak için transosseöz eşdeğeri çift sıra tamirin daha etkili olduğu inancındayız.
Anahtar Kelimeler:

Tek sıra tamir, çift sıra tamir, rotator kaf, transosseöz eşdeğeri

Comparison of Transosseous Equivalent Double Row Reapair and Single Row Repair Techniques for the Treatment of Rotator Cuff Tear

In this study, patients in group 1 with the diagnosis of rotator cuff tear applied arthroscopic single row repair and patients in group 2 with the diagnosis of rotator cuff tear applied arthroscopic double row repair (transosseous equivalent). And then the results of both group were compared, activities of surgical methods were evaluated.          Between May 2006 and December 2011, 73 shoulders of 71 patients that are diagnosed with rotator cuff tear and applied arthroscopic single or double row (transosseous equivalent) repair were included in the study. Mean follow-up of the patients 33.01 ± 17.37 (12-78) months.       The groups were compared accordingto age, sex, part, reason of being tear, tear size, preoperative and postoperative range of motion of shoulder, muscle strength, preoperative and postoperative VAS, RC-QOL, ASES, Constant Murley, UCLA scores.             Postoperative MR images of the patientsexamined. In group 1; 23 (79.3%) patients had improvement in full-thickness, 6 (20.7%) patients were also re-tear. In Group 2; 1 (2.3%) patients had partial improvement, 38 (86.4%) patients had improvement in full-thickness, 5 (11.4%) patientswerealso re-tear. Specially, we believe that the double row repair (transosseous equivalent) is more effective for the large size tears and decrease development of re-tear.
Keywords:

single row repair, double row repair, rotator cuff, transosseous equivalent,

PDF

___

  • 1. Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL. Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg. 2006;15(3):290-9.
  • 2. Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86-A(2):219-24.
  • 3. Gleyze P, Thomazeau H, Flurin PH, Lafosse L, Gazielly DF, Allard M. [Arthroscopic rotator cuff repair: a multicentric retrospective study of 87 cases with anatomical assessment]. Rev Chir Orthop Reparatrice Appar Mot. 2000;86(6):566-74.
  • 4. Harryman DT, 2nd, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA, 3rd. Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991;73(7):982-9.
  • 5. Ozbaydar MU, Tonbul M, Tekin AC, Yalaman O. [Arthroscopic rotator cuff repair: evaluation of outcomes and analysis of prognostic factors]. Acta Orthop Traumatol Turc. 2007;41(3):169-74.
  • 6. Nho SJ, Yadav H, Pensak M, Dodson CC, Good CR, MacGillivray JD. Biomechanical fixation in arthroscopic rotator cuff repair. Arthroscopy. 2007;23(1):94-102, e1.
  • 7. Lo IK, Burkhart SS. Double-row arthroscopic rotator cuff repair: re-establishing the footprint of the rotator cuff. Arthroscopy. 2003;19(9):1035-42.
  • 8. Meier SW, Meier JD. Rotator cuff repair: the effect of double-row fixation on three-dimensional repair site. J Shoulder Elbow Surg. 2006;15(6):691-6.
  • 9. Tuoheti Y, Itoi E, Yamamoto N, Seki N, Abe H, Minagawa H, et al. Contact area, contact pressure, and pressure patterns of the tendon-bone interface after rotator cuff repair. Am J Sports Med. 2005;33(12):1869-74.
  • 10. Kim DH, Elattrache NS, Tibone JE, Jun BJ, DeLaMora SN, Kvitne RS, et al. Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Am J Sports Med. 2006;34(3):407-14.
  • 11. Snyder SJ. Technique of arthroscopic rotator cuff repair using implantable 4-mm Revo suture anchors, suture Shuttle Relays, and no. 2 nonabsorbable mattress sutures. Orthop Clin North Am. 1997;28(2):267-75.
  • 12. Smith CD, Alexander S, Hill AM, Huijsmans PE, Bull AM, Amis AA, et al. A biomechanical comparison of single and double-row fixation in arthroscopic rotator cuff repair. J Bone Joint Surg Am. 2006;88(11):2425-31.
  • 13. Bardana DD, Burks RT, West JR, Greis PE. The effect of suture anchor design and orientation on suture abrasion: An in vitro study. Arthroscopy. 2003;19(3):274-81.
  • 14. Ozbaydar M, Elhassan B, Warner JJ. The use of anchors in shoulder surgery: a shift from metallic to bioabsorbable anchors. Arthroscopy. 2007;23(10):1124-6.
  • 15. Fealy S, Kingham TP, Altchek DW. Mini-open rotator cuff repair using a two-row fixation technique: outcomes analysis in patients with small, moderate, and large rotator cuff tears. Arthroscopy. 2002;18(6):665-70.
  • 16. Ma CB, Comerford L, Wilson J, Puttlitz CM. Biomechanical evaluation of arthroscopic rotator cuff repairs: double-row compared with single-row fixation. J Bone Joint Surg Am. 2006;88(2):403-10.
  • 17. Baums MH, Buchhorn GH, Spahn G, Poppendieck B, Schultz W, Klinger HM. Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material. Knee Surg Sports Traumatol Arthrosc. 2008;16(11):1052-60.
  • 18. Apreleva M, Ozbaydar M, Fitzgibbons PG, Warner JJ. Rotator cuff tears: the effect of the reconstruction method on three-dimensional repair site area. Arthroscopy. 2002;18(5):519-26.
  • 19. Meier SW, Meier JD. The effect of double-row fixation on initial repair strength in rotator cuff repair: a biomechanical study. Arthroscopy. 2006;22(11):1168-73.
  • 20. Park MC, Cadet ER, Levine WN, Bigliani LU, Ahmad CS. Tendon-to-bone pressure distributions at a repaired rotator cuff footprint using transosseous suture and suture anchor fixation techniques. Am J Sports Med. 2005;33(8):1154-9.
  • 21. Demirhan M, Atalar AC, Kilicoglu O. Primary fixation strength of rotator cuff repair techniques: a comparative study. Arthroscopy. 2003;19(6):572-6.
  • 22. Waltrip RL, Zheng N, Dugas JR, Andrews JR. Rotator cuff repair. A biomechanical comparison of three techniques. Am J Sports Med. 2003;31(4):493-7.
  • 23. Zheng N, Harris HW, Andrews JR. Failure analysis of rotator cuff repair: a comparison of three double-row techniques. J Bone Joint Surg Am. 2008;90(5):1034-42.
  • 24. Ozbaydar M, Elhassan B, Esenyel C, Atalar A, Bozdag E, Sunbuloglu E, et al. A comparison of single-versus double-row suture anchor techniques in a simulated repair of the rotator cuff: an experimental study in rabbits. J Bone Joint Surg Br. 2008;90(10):1386-91.
  • 25. Park JY, Lhee SH, Choi JH, Park HK, Yu JW, Seo JB. Comparison of the clinical outcomes of single- and double-row repairs in rotator cuff tears. Am J Sports Med. 2008;36(7):1310-6.
  • 26. Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am. 2005;87(6):1229-40.
  • 27. Calvert PT, Packer NP, Stoker DJ, Bayley JI, Kessel L. Arthrography of the shoulder after operative repair of the torn rotator cuff. J Bone Joint Surg Br. 1986;68(1):147-50.
  • 28. Charousset C, Duranthon LD, Grimberg J, Bellaiche L. [Arthro-C-scan analysis of rotator cuff tears healing after arthroscopic repair: analysis of predictive factors in a consecutive series of 167 arthroscopic repairs]. Rev Chir Orthop Reparatrice Appar Mot. 2006;92(3):223-33.
  • 29. Gerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000;82(4):505-15.
  • 30. Liu SH, Baker CL. Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy. 1994;10(1):54-60.
  • 31. Franceschi F, Ruzzini L, Longo UG, Martina FM, Zobel BB, Maffulli N, et al. Equivalent clinical results of arthroscopic single-row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial. Am J Sports Med. 2007;35(8):1254-60.
  • 32. Charousset C, Grimberg J, Duranthon LD, Bellaiche L, Petrover D. Can a double-row anchorage technique improve tendon healing in arthroscopic rotator cuff repair?: A prospective, nonrandomized, comparative study of double-row and single-row anchorage techniques with computed tomographic arthrography tendon healing assessment. Am J Sports Med. 2007;35(8):1247-53.
  • 33. Gerber C, Schneeberger AG, Beck M, Schlegel U. Mechanical strength of repairs of the rotator cuff. J Bone Joint Surg Br. 1994;76(3):371-80.
  • 34. Burkhart SS, Diaz Pagan JL, Wirth MA, Athanasiou KA. Cyclic loading of anchor-based rotator cuff repairs: confirmation of the tension overload phenomenon and comparison of suture anchor fixation with transosseous fixation. Arthroscopy. 1997;13(6):720-4.
  • 35. Anderson K, Boothby M, Aschenbrener D, van Holsbeeck M. Outcome and structural integrity after arthroscopic rotator cuff repair using 2 rows of fixation: minimum 2-year follow-up. Am J Sports Med. 2006;34(12):1899-905.
  • 36. Huijsmans PE, Pritchard MP, Berghs BM, van Rooyen KS, Wallace AL, de Beer JF. Arthroscopic rotator cuff repair with double-row fixation. J Bone Joint Surg Am. 2007;89(6):1248-57.
  • 37. Mahar A, Tamborlane J, Oka R, Esch J, Pedowitz RA. Single-row suture anchor repair of the rotator cuff is biomechanically equivalent to double-row repair in a bovine model. Arthroscopy. 2007;23(12):1265-70.
  • 38. Nelson CO, Sileo MJ, Grossman MG, Serra-Hsu F. Single-row modified mason-allen versus double-row arthroscopic rotator cuff repair: a biomechanical and surface area comparison. Arthroscopy. 2008;24(8):941-8.
  • 39. Sugaya H, Maeda K, Matsuki K, Moriishi J. Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation. Arthroscopy. 2005;21(11):1307-16.
  • 40. Brady PC, Arrigoni P, Burkhart SS. Evaluation of residual rotator cuff defects after in vivo single- versus double-row rotator cuff repairs. Arthroscopy. 2006;22(10):1070-5.
  • 41. Aydin N, Kocaoglu B, Guven O. Single-row versus double-row arthroscopic rotator cuff repair in small- to medium-sized tears. J Shoulder Elbow Surg. 2010;19(5):722-5.
  • 42. Buess E, Waibl B, Vogel R, Seidner R. A comparative clinical evaluation of arthroscopic single-row versus double-row supraspinatus tendon repair. Acta Orthop Belg. 2009;75(5):588-94.
  • 43. Reardon DJ, Maffulli N. Clinical evidence shows no difference between single- and double-row repair for rotator cuff tears. Arthroscopy. 2007;23(6):670-3.
  • 44. Wall LB, Keener JD, Brophy RH. Clinical outcomes of double-row versus single-row rotator cuff repairs. Arthroscopy. 2009;25(11):1312-8.
  • 45. Duquin TR, Buyea C, Bisson LJ. Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review. Am J Sports Med. 2010;38(4):835-41.
  • 46. Saridakis P, Jones G. Outcomes of single-row and double-row arthroscopic rotator cuff repair: a systematic review. J Bone Joint Surg Am. 2010;92(3):732-42.
  • 47. Nho SJ, Slabaugh MA, Seroyer ST, Grumet RC, Wilson JB, Verma NN, et al. Does the literature support double-row suture anchor fixation for arthroscopic rotator cuff repair? A systematic review comparing double-row and single-row suture anchor configuration. Arthroscopy. 2009;25(11):1319-28.
  • 48. Grasso A, Milano G, Salvatore M, Falcone G, Deriu L, Fabbriciani C. Single-row versus double-row arthroscopic rotator cuff repair: a prospective randomized clinical study. Arthroscopy. 2009;25(1):4-12.
  • 49. Burks RT, Crim J, Brown N, Fink B, Greis PE. A prospective randomized clinical trial comparing arthroscopic single- and double-row rotator cuff repair: magnetic resonance imaging and early clinical evaluation. Am J Sports Med. 2009;37(4):674-82.
  • 50. Gartsman GM DG, Edwards TB, Elkousy HA, Hammerman SM, O’Connor DP. Ultrasound evaluation of arthroscopic full-thickness supraspinatus rotator cuff repair: Single-row versus double-row suture bridge (transosseous equivalent) fixation. Results of a randomized, prospective study. American Society of Shoulder and Elbow Surgeons 2010 Specialty Day.New Orleans, LA; March 2010.
Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dergisi-Cover
  • ISSN: 1309-3320
  • Başlangıç: 2009
  • Yayıncı: Tokat Gaziosmanpaşa Üniversitesi
Arşiv
Sayıdaki Diğer Makaleler

Rotator Manşet Yırtığı Tedavisinde Artroskopik Tek ve Çift Sıra (Transosseöz Eşdeğeri) Tamir Tekniklerinin Karşılaştırılması

Recep KURNAZ

Nadir Bir Anüri Nedeni; Sağ Renal Arter Stenozu ile Eşzamanlı Sol Böbrek ve Üreter Taşı

Şahin KILIÇ, Aşkın EROĞLU

İkinci Trimester Gebelikte Tanı Konulan Mide Kanseri Vakası

Tayfur ÇİFT, Muzaffer TEMUR, Engin KORKMAZER, Emin ÜSTÜNYURT, Bülent ÇAKMAK, Beril ŞENKUTLU, Sabiha TUZLUOĞLU

Propofol Enjeksiyon Ağrısının Önlenmesinde Deksketoprofen ve Tenoksikamın Etkileri

Özgür YAĞAN, Tuğçe MUTLU, Ebru ÇANAKÇI, Nilay TAŞ, B. Serhan YURTLU, Volkan HANCI

Ruh sağlığı ve Hastalıkları Bölümünden İstenen Konsültasyonlarıngeriye Dönük İncelenmesi

Filiz ÖZSOY