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Öğe Could superior capsule findings be used as a predictor for partial bursal-sided rotator cuff tears?(Sage Publications Ltd, 2020) Kanatli, Ulunay; Ayanoglu, Tacettin; Esen, Erdinc; Ataoglu, Baybars; Ozer, Mustafa; Cetinkaya, Mehmet; Kaptan, Ahmet YigitPurpose: The purpose of this study was to investigate the relationship between the superior capsule tear patterns and synovitis with subacromial pathologies, such as bursal-sided rotator cuff tear and subacromial impingement syndrome. Methods: Fifty patients who underwent arthroscopic treatment for isolated bursal-sided tear were included in the study. Fifty more patients who underwent arthroscopic treatment for isolated Superior Labrum Anterior Posterior (SLAP) 2 lesion without pathology in the rotator cuff were included in the control group. Firstly, superior capsule tear and common synovitis on the rotator cable were assessed during glenohumeral joint examination. Coracoacromial Ligament (CAL) degeneration grading was performed according to the Royal Berkshire Hospital classification. Bursal-sided partial tear grading was done using Ellman classification. Whether or not there was a relationship between synovitis, classic capsule tear, plus reverse flap capsule tear, and partial bursal-sided tear existence. Results: There were 21 patients with reverse flap capsule tear in the study group and 3 patients in the control group. In addition, there were 13 patients with synovitis in the study group and 4 in the control group. Compared to the control group, there was also a significant positive correlation in the presence of both synovitis and reverse flap capsule tear with the presence of bursal-sided tear in the study group (p = 0.000). There was, however, no significant difference between the presence of classical capsule tear and the presence of bursal-sided tear (p = 0.485). Conclusion: This study shows that the presence of reverse flap capsule tear and synovitis was associated with partial bursal-sided tears. Therefore, if the reverse flap capsule tear or synovitis is detected in the superior capsule, the rotator cuff should be evaluated in more detail during subacromial bursoscopy in order not to miss a bursal-sided partial cuff tear.Öğe The effect of bicipital groove morphology on the stability of the biceps long head tendon(Springer, 2021) Ulucakoy, Coskun; Kaptan, Ahmet Yigit; Yapar, Aliekber; Orhan, Ozlem; Ozer, Mustafa; Kanatli, UlunayBackgroundLong head of biceps tendon (LHBT) instability is an important source of pain and disability for the shoulder. Supraspinatus and subscapularis tendons contribute to the formation of the biceps pulley system, which maintains biceps stability during shoulder movements. The aim of this study is to evaluate the effect of morphology of bicipital groove on the stability of LHBT. Also, to evaluate the relationship between bicipital groove morphology and subscapularis rupture and supraspinatus rupture.Material and methodsSurgical images and magnetic resonance images of 200 patients who underwent shoulder arthroscopy surgery in our clinic between January 2016 and December 2017 were retrospectively analyzed. The depth of groove, medial wall angle and opening angle values of 200 patients were measured on MRI. The stability of the biceps long head tendon, rotator cuff tear and SLAP lesions was recorded by monitoring the shoulder arthroscopy records in each groups.ResultsThere were 200 patients, 131 male and 69 female, with an average age of 40.914.2 (range: 17.0-79.0) years. In 69 (34.5%) patients, long head of the biceps tendon (LHBT) instability was detected. The patients were divided into two groups according to LHBT instability.The subscapularis rupture was significantly more frequent in the group with LHBT instability (52.2%) than the group without LHBT instability (4.6%) (p<0.001). The supraspinatus tear was observed in 72.5% in the group with instability and 56.5% in the non-instability group, which shows a statistical difference between the two groups (p=0.027). The presence of SLAP was observed in similar rates in both groups (p=0.053). Mean depth of groove, medial wall angle, and opening angle measurements were similar in both groups (p=0.568, p=0.393 and p=0.598, respectively).ConclusionTo conclude, the morphology of the bicipital groove is not related to the stability of LHBT, and the soft tissue factors above the bicipital groove rather than bone morphology are important in stability. In addition, subscapularis rupture is a pre-disposing factor for LHBT instability; therefore, we recommend a more careful examination of LHBT in patients with subscapularis rupture.Level of evidence III.Öğe Evaluation of the relationship between scapula morphology and anterior shoulder dislocation accompanying greater tuberosity fracture(Elsevier Sci Ltd, 2023) Ozer, Mustafa; Yaka, Haluk; Turkmen, Faik; Kacira, Burkay Kutluhan; Kaptan, Ahmet Yigit; Kanatli, UlunayIntroduction: It is estimated that 5-30% of traumatic anterior shoulder dislocations are accompanied by greater tuberosity fracture (GTF), and the pathomechanism of these fractures is not yet clear. Our hypothesis is to examine the relationship between the scapula morphology and anterior shoulder dislocation (ASD) accompanying GTF. Materials and methods: The patients were divided into two groups according to the accompanying GTF. 40 patients with isolated traumatic ASD and 31 patients with accompanying GTF were included in the study. Critical shoulder angle (CSA), glenoid inclination (GI), acromial index (AI) and greater tuberosity angle (GTA) values were measured in two sessions by two independent observers in the standard antero-posterior radiographs of the patients in both groups. Results: The mean CSA was 40.82 degrees +/- 3.19 degrees and 35.49 degrees +/- 2.19 degrees in accompanying GTF group and the isolated ASD group, respectively. The mean CSA was significantly higher in accompanying GTF group than isolated ASD group (P<0.001). The GI was significantly higher in the isolated ASD than in accompanying GTF group (P = 0.001). The mean GI was 18.7 degrees +/- 6.85 degrees and 10.45 degrees +/- 4.87 degrees in accompanying GTF group and the isolated ASD, respectively. Cut-off value of CSA and GI was 38 degrees (88.2% sensitivity,88.9% specificity) and 14.5 degrees (70.6% sensitivity and 72.2% specificity), respectively. There was no significant difference regarding the mean GTA and AI values between GTF group and the isolated ASD group (P = 0.98, P = 0.63). Conclusions: Increased CSA and GI values are associated with traumatic anterior shoulder dislocation accom-panied by greater tuberosity fracture.Öğe The middle glenohumeral ligament: a classification based on arthroscopic evaluation(Mosby-Elsevier, 2022) Kaptan, Ahmet Yigit; Ozer, Mustafa; Alim, Ece; Percin, Ali; Ayanoglu, Tacettin; Ozturk, Burak Yagmur; Kanatli, UlunayBackground: Although middle glenohumeral ligament (MGHL) variations have been shown in the literature, their clinical effect and relationship with intra-articular pathologies have yet to be revealed, except for the Buford complex. This study was designed to classify MGHL and to reveal its relationship with clinical pathologies. Methods: A total of 843 consecutive shoulder arthroscopies were evaluated retrospectively, and a classification system was proposed for MGHL with regard to its structure and its relation to the anterior labrum. The associations of each MGHL type with superior labrum anterior-posterior (SLAP) lesions, subscapularis tears, and anterior instability were investigated. Results: MGHL variations were grouped into 6 types according to the classification. A significant difference in favor of type 6 MGHL (Buford complex) was observed in the distribution of SLAP lesions (P < .001). There was no significant difference between MGHL types and the distribution of anterior instability history (P = .131) and subscapularis tears (P = .324). Conclusion: SLAP lesions accompany type 6 MGHLs (Buford complex) significantly more frequently than other types. There is also a negative relation between the anterior instability and thicker MGHL variants. (C) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.Öğe Partial and full-thickness rotator cuff tears in patients younger than 45 years(Turkish Assoc Orthopaedics Traumatology, 2020) Kaptan, Ahmet Yigit; Ulucakoy, Coskun; Ozer, Mustafa; Cetinkaya, Mehmet; Ayanoglu, Tacettin; Ataoglu, Muhammet Baybars; Kanatli, UlunayObjective: The aim of this study was to evaluate the results of the arthroscopic repair in patients with partial and full thickness rotator cuff tears and less than 45 years of age. Methods: Fifty patients (26 women and 24 men; mean age: 41.4 +/- 3.96 years; range: 31-45) with rotator cuff tear, and who were treated with the arthroscopic repair, were included in the study. Twenty patients had full thickness and 30 had partial-thickness tears. The final functional evaluation was conducted at a mean of 42.4 months (range, 24 to 95 months; SD:13.3). The American Shoulder and Elbow Surgeon (ASES) self-report score and the University of California at Los Angeles Shoulder Score (UCLA Shoulder Score) were used as validated scoring systems. Results: At the final follow-up, the mean ASES and UCLA scores improved significantly to 72.3 and 26.5, respectively, in the full-thickness group (p<0.01). The mean ASES and UCLA scores improved significantly to 70.7 and 25.3, respectively, in the bursal-side group (p<0.01). The mean ASES and UCLA scores improved significantly to 75.3 and 27.1, respectively, in the joint-side group (p<0.01). There were no significant differences between the groups according to the postoperative ASES score (p>0.06) and UCLA score (p<0.37). Conclusion: The arthroscopic repair of the joint-sided tears and bursal-sided tears has good functional outcomes as full thickness rotator cuff tears, and the surgical option should be considered in younger population if the conservative treatment fails.Öğe Untitled Reply(Sage Publications Ltd, 2020) Kanatli, Ulunay; Ayanoglu, Tacettin; Esen, Erdinc; Ataoglu, Muhammet Baybars; Ozer, Mustafa; Cetinkaya, Mehmet; Kaptan, Ahmet Yigit[Abstract Not Availabe]