Masif posterosuperior rotator manşet yırtıklarında postoperatif klinik sonuçların; yırtık tipi ve skapula morfolojisi ile ilişkisinin değerlendirilmesi
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Masif posterosuperior rotator manşet yırtıklarında postoperatif dönemde ki klinik sonuçların yırtık
tipi ve skapula morfolojisi arasında ki ilişkinin araştırılması planlandı.
Yöntem: Necmettin Erbakan Üniversitesi Tıp Fakültesi Hastanesi hasta arşivinden 2016 Ocak ile 2022
Ocak tarihleri arasında omuz artroskopisi operasyonu yapılan 1126 hasta retrospektif olarak tarandı. Çalışmamıza
dahil edilme kriterleri; hastaların 18 yaş üzeri olması ve artroskopik olarak tamir edilebilir masif posterosuperior
rotator manşet yırtığı olduğunun gösterilmesidir. Bu çalısmada dışlanan hasta grupları ise; tamir edilemez veya
parsiyel tamir yapılan hastalar, daha önce üst ekstremite cerrahisi geçiren hastalar, donuk omuz bulguları olan
hastalar, subskapularis yırtığı olan hastalar, omuz artrozu olan hastalar, nörolojik ve hematolojik hastalığı olan
hastalar ve iki yıllık klinik sonuçların elde edilmesi için ulaşılamayan veya ex olan hastalar olarak belirlendi.
Çalışma kriterlerini karşılayan 61 hasta çalışmaya dahil edildi. Masif posterosuperior rotator manşet yırtığı olan
hastalarda omuz ap grafide kritik omuz açısı ve MR görüntülemede sagittal akromial slop, glenoid inklinasyonu,
glenoid versiyonu ve lateral akromial açı ölçümü yapıldı. Elde edilen veriler IBM-SPSS-version 22 ile analiz
edildi.
Bulgular: Çalışmaya dahil edilen hastaların 26’sı(%42,6) erkek 35’i(%57,4) kadın, kontrol grubu
hastaların 24’ü(%44,4) erkek 30’u(%55,6) kadındı. Hastaların 41’inde(%67,2) sağ 20’sinde(%32,8) sol tarafta
patoloji vardı. Kontrol gurubunda ise 38(%70,3) sağ 16(%29,7) sol taraf radyolojik görüntülemelerinde ölçüm
yapıldı. Hastaların tümünde masif posterosüperior rotator manşet yırtığı olup eşlik eden subskapularis yırtığı
yoktu. Hasta olan grup ile kontrol grubu arasında yapılan ölçümlerde radyolojik ölçümler açısından istastiksel
olarak anlamlı fark tespit edildi. Ölçümlerde hasta olan grupta kontrol grubuna göre kritik omuz açısı(p<0.001) ve
sagittal akromial slop açısı(p=0,033) artarken lateral akromial açıda(p=0.040) ise azalma tespit edildi. Hasta olan
gurup yırtık tipine göre ayrıldığında ise; rotator kablo yırtık olan gurup ile rotator kablo sağlam olan gurup arasında
radyolojik parametreler ve postop klinik sonuçlar açısından anlamlı bir fark yoktu.
Sonuç: Bu çalışma, masif posterosuperior rotator manşet yırtıklarında postoperatif klinik sonuçları
etkileyebilecek iki önemli faktörü, yırtık tipini ve skapula morfolojisini incelemiştir. Sonuç olarak rotator manşet
rüptürünü, risk faktörleri açısından multifaktöriyel değerlendirmenin yanı sıra sagittal planda ki akromion
eğiminin de dikkate alınması gerektiğini düşünmekteyiz.
Objective: It was planned to investigate the relationship between tear type and scapula morphology in postoperative clinical outcomes in massive posterosuperior rotator cuff tears. Method: 1126 patients who underwent shoulder arthroscopy operations between January 2016 and January 2022 were retrospectively scanned from the patient archives of Necmettin Erbakan University Faculty of Medicine Hospital. Criteria for inclusion in our study; The patients must be over 18 years of age and have been shown to have a massive posterosuperior rotator cuff tear that can be repaired arthroscopically. The patient groups excluded in this study are; patients who have undergone irreparable or partial repair, patients who have previously undergone upper extremity surgery, patients with frozen shoulder findings, patients with subscapularis tear, patients with shoulder arthrosis, patients with neurological and hematological diseases, and patients who cannot be reached for two-year clinical results or who are dead were identified as patients. 61 patients who met the study criteria were included in the study. In patients with massive posterosuperior rotator cuff tears, critical shoulder angle was measured on shoulder AP radiograph and sagittal acromial slope, glenoid inclination, glenoid version and lateral acromial angle were measured on MRI. The obtained data were analyzed with IBM-SPSS-version 22. Results: 26 (42.6%) of the patients included in the study were male and 35 (57.4%) were female, and 24 (44.4%) of the control group patients were male and 30 (55.6%) were female. 41 (67.2%) of the patients had pathology on the right side and 20 (32.8%) had pathology on the left side. In the control group, measurements were made on 38 (70.3%) right and 16 (29.7%) left side radiological images. All patients had massive posterosuperior rotator cuff tears and no accompanying subscapularis tears. A statistically significant difference was detected in terms of radiological measurements between the patient group and the control group. In the measurements, while the critical shoulder angle (p<0,001) and sagittal acromial slope angle (p = 0.033) increased in the patient group compared to the control group, a decrease was detected in the lateral acromial angle (p = 0.040). When the patient group is divided according to the type of tear; There was no significant difference in radiological parameters and postoperative clinical results between the group with rotator cable rupture and the group with intact rotator cable. Conclusion: This study examined two important factors that may affect postoperative clinical outcomes in massive posterosuperior rotator cuff tears, tear type and scapula morphology. As a result, we think that in addition to a multifactorial evaluation of rotator cuff rupture in terms of risk factors, the acromion slope in the sagittal plane should also be taken into account.
Objective: It was planned to investigate the relationship between tear type and scapula morphology in postoperative clinical outcomes in massive posterosuperior rotator cuff tears. Method: 1126 patients who underwent shoulder arthroscopy operations between January 2016 and January 2022 were retrospectively scanned from the patient archives of Necmettin Erbakan University Faculty of Medicine Hospital. Criteria for inclusion in our study; The patients must be over 18 years of age and have been shown to have a massive posterosuperior rotator cuff tear that can be repaired arthroscopically. The patient groups excluded in this study are; patients who have undergone irreparable or partial repair, patients who have previously undergone upper extremity surgery, patients with frozen shoulder findings, patients with subscapularis tear, patients with shoulder arthrosis, patients with neurological and hematological diseases, and patients who cannot be reached for two-year clinical results or who are dead were identified as patients. 61 patients who met the study criteria were included in the study. In patients with massive posterosuperior rotator cuff tears, critical shoulder angle was measured on shoulder AP radiograph and sagittal acromial slope, glenoid inclination, glenoid version and lateral acromial angle were measured on MRI. The obtained data were analyzed with IBM-SPSS-version 22. Results: 26 (42.6%) of the patients included in the study were male and 35 (57.4%) were female, and 24 (44.4%) of the control group patients were male and 30 (55.6%) were female. 41 (67.2%) of the patients had pathology on the right side and 20 (32.8%) had pathology on the left side. In the control group, measurements were made on 38 (70.3%) right and 16 (29.7%) left side radiological images. All patients had massive posterosuperior rotator cuff tears and no accompanying subscapularis tears. A statistically significant difference was detected in terms of radiological measurements between the patient group and the control group. In the measurements, while the critical shoulder angle (p<0,001) and sagittal acromial slope angle (p = 0.033) increased in the patient group compared to the control group, a decrease was detected in the lateral acromial angle (p = 0.040). When the patient group is divided according to the type of tear; There was no significant difference in radiological parameters and postoperative clinical results between the group with rotator cable rupture and the group with intact rotator cable. Conclusion: This study examined two important factors that may affect postoperative clinical outcomes in massive posterosuperior rotator cuff tears, tear type and scapula morphology. As a result, we think that in addition to a multifactorial evaluation of rotator cuff rupture in terms of risk factors, the acromion slope in the sagittal plane should also be taken into account.
Açıklama
Anahtar Kelimeler
Rotator manşet rüptürü, Rotator cuff rupture, sagittal akromial slop, sagittal acromial slope, rotator kablo, rotator cable
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Harmankaya, M. (2024). Masif posterosuperior rotator manşet yırtıklarında postoperatif klinik sonuçların; yırtık tipi ve skapula morfolojisi ile ilişkisinin değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Ortopedi ve Travmatoloji Anabilim Dalı, Konya.
