Publication: Rotator kılıf yırtıklarında açık cerrahi onarımın uzun dönem sonuçları
Abstract
Amaç: Rotator kılıf yırtıklarının açık cerrahi ile tedavisinin uzun dönem sonuçları değerlendirildi. Çalışma planı: Çalışmada rotator kılıf yırtığı nedeniyle açık cerrahi tamir ve akromiyoplasti uygulanan 88 hastanın (36 kadın, 52 erkek; ort. yaş 57; dağılım 36-75) 90 omzunda uzun dönem sonuçlar değerlendirildi. Ameliyat sonrasında üç aşamalı rehabilitasyon programı uygulandı. Objektif değerlendirme Constant-Murley skorlama sistemiyle yapıldı. Ağrı sübjektif olarak görsel analog skala kullanılarak ölçüldü. Ortalama izlem süresi 61 ay (dağı-lım 24-102 ay) idi. Sonuçlar: Ameliyat öncesinde 41.7 (dağılım 12-82) bulunan Constant-Murley skoru ortalaması, ameliyat sonra-sı dönemde 79.7'ye (42-100) yükseldi (p<0.0001). Görsel analog skala ortalama skoru ameliyat öncesinde 7.5 (dağılım 4-10), ameliyat sonrasında 1.25 (dağılım 0-5) bu-lundu (p<0.0001). Sadece sekiz hastanın (%9) ameliyattan memnun olmadığı öğrenildi. Ameliyattan memnun olan 80 hastada (%91) gece uyku düzeni ve günlük aktivitelere dönüş sağlandı. Hastaların hiçbirinde cerrahi sonrası sinir paralizisi ve omuz fonksiyon kısıtlılığına rastlanmadı. İki hastada (%2.2) yüzeyel yumuşak doku enfeksiyonu gelişti ve pansumanlarla iyileşti. Çıkarımlar: Açık cerrahi tedavi ve akromiyoplastinin uzun dönem sonuçları, yöntemin rotator kılıf yırtıklarının tedavisinde etkili olduğunu göstermektedir.
Objectives: We evaluated the long-term results of rotator cuff tears treated by open surgical repair. Methods: Ninety shoulders of 88 patients(36 females, 52 males; mean age 57 years; range 36 to 75 years) with rota-tor cuff tears were treated by open surgical repair and acromioplasty. A three-staged rehabilitation program was implemented following surgery. Objective evaluations were made with the use of the Constant-Murley scoring system. Pain was assessed through a visual analog scale. The mean follow-up period was 61 months (range 24 to 102 months). Results: The mean Constant-Murley score increased from preoperative 41.7 (range 12 to 82) to postoperative 79.7 (range 42 to 100) (p<0.0001). The mean preoperative and postoperative pain scores were 7.5 (range 4 to 10) and 1.25 (range 0 to 5), respectively (p<0.0001). Only eight patients (9%) showed dissatisfaction with the surgical outcome. The remaining 80 patients (91%) were satisfied with the out-come and returned to their previous night comfort and daily activities. None of the patients had postoperative nerve palsy or limitations in shoulder functions. Two patients (2.2%) developed superficial soft tissue infections that disappeared following multiple wound debridements. Conclusion: Our longterm results favor open surgical repair and acromioplasty in the treatment of patients with rotator cuff tears.
Objectives: We evaluated the long-term results of rotator cuff tears treated by open surgical repair. Methods: Ninety shoulders of 88 patients(36 females, 52 males; mean age 57 years; range 36 to 75 years) with rota-tor cuff tears were treated by open surgical repair and acromioplasty. A three-staged rehabilitation program was implemented following surgery. Objective evaluations were made with the use of the Constant-Murley scoring system. Pain was assessed through a visual analog scale. The mean follow-up period was 61 months (range 24 to 102 months). Results: The mean Constant-Murley score increased from preoperative 41.7 (range 12 to 82) to postoperative 79.7 (range 42 to 100) (p<0.0001). The mean preoperative and postoperative pain scores were 7.5 (range 4 to 10) and 1.25 (range 0 to 5), respectively (p<0.0001). Only eight patients (9%) showed dissatisfaction with the surgical outcome. The remaining 80 patients (91%) were satisfied with the out-come and returned to their previous night comfort and daily activities. None of the patients had postoperative nerve palsy or limitations in shoulder functions. Two patients (2.2%) developed superficial soft tissue infections that disappeared following multiple wound debridements. Conclusion: Our longterm results favor open surgical repair and acromioplasty in the treatment of patients with rotator cuff tears.