All-Arthroscopic Versus Mini-Open Rotator Cuff Repair: Isokinetic Muscle Strength, Shoulder Joint Position Sense and Functional Outcomes

Objectives: All-arthroscopic surgery and mini-open surgery for repairing rotator cuff tears are widely used and clinically developed. The purpose of our study is to compare the functional results, isokinetic shoulder muscle strength and shoulder position sense of patients who have undergone all-arthroscopic and mini-open surgery to repair their rotator cuff tears. Material and Methods: The results from 28 patients (20 females and 8 males) with isolated rotator cuff tears were evaluated. Twelve had have all-arthroscopic surgery (ASR) (mean age 54.3 yrs) and 16 had have mini-open surgery (MOP) (mean age 51.5 yrs). Clinical and functional results were compared using the American Shoulder and Elbow Surgeons (ASES), and Disabilities of the Arm, Shoulder and Hand (DASH) indices. Shoulder Muscle Strength and shoulder joint position sense were measured with an isokinetic dynamometer (CSMI Humac Norm, USA). Results: Mean age of the patients was 52.8 yrs (min-max: 40-67). Mean post-operative ASES and DASH scores of ASR-operated patients were 78 and 18.8, respectively. MOP- implemented patients had mean ASES and DASH scores of 86 and 13.6, respectively. As for functional results, there was no statistically significant difference (p>0.05). For patients who went through either surgery, there were no statistically significant different result in terms of isokinetic shoulder muscle strength (internal rotation, external rotation, adduction, abduction) and joint position sense results (p>0.05). Conclusion: There were no significant differences between two methods in means of functional outcomes, joint strength and position sense. But, these two methods should be investigated by more comprehensive studies.

Amaç: Rotator manşetin artroskopik ve mini açık onarımları klinik pratikte sıklıkla kullanılmakta ve geliştirilmektedir. Bu çalışmanın amacı artroskopik ve mini açık cerrahi ile rotator manşet onarımı yapılan hastaların; fonksiyonel sonuçlarını, izokinetik omuz kas kuvvetlerini ve eklem pozisyon hissini karşılaştırmaktır. Gereç ve yöntem: İzole rotator manşet yırtığı ile tedavi edilen ve izlenen 28 hastanın (20 kadın, 8 erkek) sonuçları değerlendirildi. Hastaların 12’si artroskopik (yaş ortalaması 54.3 yıl), 16’sı ise mini-açık teknikle (yaş ortalaması 51.5 yıl) tedavi edildi. Klinik ve fonksiyonel sonuçlar, Amerikan Omuz ve Dirsek Cerrahları (American Shoulder and Elbow Surgeons; ASES) ve Kol, Omuz ve El Özürlülükleri (Disabilities of the Arm, Shoulder and Hand; DASH) ölçekleri kullanılarak değerlendirildi. Omuz kas kuvveti ve ekleminin pozisyon hissi Cybex Norm (CSMI Humac Norm, ABD) izokinetik dinamometre ile ölçüldü. Bulgular: Hastaların yaş ortalaması 52.8 (min -maks: 40-67) yıldı. Artroskopik tamir ile tedavi edilen hastaların ortalama postoperatif ASES skoru 78, DASH skoru 18.8 puandı. Mini-açık cerrahi tekniği ile tedavi edilen hastaların ortalama postoperatif ASES skoru 86, DASH skoru 13.6 puandı. Fonksiyonel sonuçlar açısından istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Mini-açık veya artroskopik teknik uygulanan hastaların izokinetik omuz kas kuvveti (iç-dış rotasyon ve adduksiyon -abduksiyon) ve eklem pozisyon hissi ölçümlerinde istatistiksel olarak anlamlı fark belirlenmedi (p>0.05). Sonuç: İki yöntem karşılaştırıldığında; fonksiyonel sonuçlar, izokinetik kuvvet ve eklem pozisyon hissi yönünden anlamlı farklılık görülmemiştir. Ancak bu iki yöntem arasındaki farkların daha kapsamlı çalışmalarla değerlendirilmesi gerektiği düşünülmektedir.

Kaynakça

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Kaynak Göster

Spor Hekimliği Dergisi
  • ISSN: 1300-0551
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1966

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