Kronik Rotator Manşet Yırtıklarının Cerrahi Tedavisinde Klinik Sonuçlarımız: Retrospektif Karşılaştırmalı Çalışma

Bu çalışmada, tam kat rotator manşet yırtıklarının cerrahi tedavisinde artroskopik yardımlı mini açık yöntem ile tam artroskopik yöntemin klinik sonuçlarının karşılaştırılması amaçlandı. Kliniğimizde 2017-2018 yılları arasında tam kat rotator manşet yırtığı nedeniyle cerrahi tedavisi yapılan ve en az bir yıl takip edilen 42 hastanın sonuçları retrospektif olarak değerlendirildi. Hastaların tanısı klinik fizik muayene ve manyetik rezonans görüntüleme ile konuldu. Hastalar tedavi yöntemine göre iki gruba ayrıldı. Grup 1 (Tam Artroskopik) 25 hastandan ve Grup 2 (Artroskopik yardımlı mini açık) 17 hastadan oluşmaktaydı. Hastaların klinik sonuçlarının değerlendirilmesinde UCLA (University of California Los Angeles) ve ASES (American Shoulder and Elbow Surgeons) skorları kullanıldı. Rotator manşet yırtıkları boyutuna göre küçük,orta, geniş olarak sınıflandırıldı. Hastaların hepsine hastanemizde aynı fizik tedavi protokolü uygulandı. Gruplar arasında, cinsiyet, taraf, ek patoloji, ameliyat ve hastanede kalış süreleri bakımından anlamlı farklılık saptanmadı(sırasıyla p=0.952; p=0.716; p=0.952; p=0.88 ve p=0.138). Rotator manşet yırtığının boyutunda (küçük, orta, geniş yırtık) gruplar arasında anlamlı farklılık bulunamadı(p=0.158). Grupların preoperatif, 6. ay ve 1. yıl UCLA skorlarında istatistiksel olarak benzer bulundu (sırasıyla p=0.979; p=0.678 ve p=0.676). Benzer şekilde ASES skorlarında da gruplar arası anlamlı farklılık bulunamadı (sırasıyla p=0.083; p=0.154 ve p=0.795). Diğer yandan grup içi değerlendirmede preoperatif UCLA skorlarına göre, postoperatif 6. ay ve 1. yıl skorları istatistiksel olarak daha iyiydi (p<0.001). Yine preoperatif ASES skorlarına göre, postoperatif 6. ay ve 1. yıl skorları istatistiksel olarak anlamlıydı.(p<0.001). Bu çalışmanın sonuçları, hastaların her iki tedavi yönteminden de fayda gördüğü ve artroskopik yardımlı mini açık ve sadece artroskopik yöntemin sonuçlarının benzer olduğunu göstermektedir.

Anahtar Kelimeler:

Artroskopik Cerrahi, Mini Açık Teknik, Rotator Manşet, Tam Kat Yırtık

Surgical Treatment Outcome of Chronic Rotator Cuff Tears: A Retrospective Comparative Study

In this study, we aimed to compare the clinical results of the arthroscopic assisted Mini open method and the Arthroscopic method in the surgical treatment of full thickness rotator cuff tears. The results of 42 patients, who underwent surgical treatment and followed for at least one year due to full-length rotator cuff tear in our clinic between 2017-2018, were evaluated retrospectively. The diagnosis of the patients was made by clinical physical examination and magnetic resonance imaging. The patients were divided into two groups according to the treatment method. Group 1 (Full Arthroscopic) consisted of 25 patients and Group 2 (Arthroscopic assisted Mini open) consisted of 17 patients. UCLA (University of California Los Angeles) and ASES (American Shoulder and Elbow Surgeons) scores were used to evaluate the clinical results of the patients. Rotator cuff tears were classified as small, medium or large according to their size. The same physical therapy protocol was applied to all patients in our hospital. There was no significant difference between the groups in terms of gender, side, additional pathology (p=0.952; p=0.622; p=0.952; p=0.88 and p=0.138 respectively). There is no significant difference in the size of the rotator cuff tear (small, medium, large tear) between the groups (p=0.158). There was no statistical difference in preoperative, 6th and 1st year UCLA scores of the groups (p=0.979, p=0.678 and p=0.676, respectively). Similarly, there was no significant difference between the groups in ASES scores (p=0.083; p=0.154 and p=0.795, respectively). On the other hand, postoperative 6th and 1st year scores were statistically better than preoperative UCLA scores in intragroup evaluation (p<0.001). Also, according to preoperative ASES scores, postoperative 6th month and 1st year scores were found statistically higher (p<0.001). The results of this study show that patients were benefited from both two treatment methods and it was detected that arthroscopic-assisted mini-open and full arthroscopic method have similar outcomes.

Keywords:

Arthroscopic Surgery, Full Thickness Tear, Mini Open Technique, Rotator Cuff,

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