TRAVMATİK ANTERİOR OMUZ İNSTABİLİTESİNDE AÇIK VE ARTROSKOPİK BANKART TAMİRİ SONUÇLARININ KARŞILAŞTIRILMASI Comparison of Open and Arthroscopic Bankart Repair Results in Traumatic Anterior Shoulder Instability

OZET Amac: Travmatik anterior omuz instabilitesi cerrahi tedavisinde acik ve artroskopik Bankart tamirinin klinik sonuclarinin karsilastirilmasi amaclandi. Materyal ve Metod: Ocak 2005 ile Ocak 2013 yillari arasinda tekrarlayan anterior omuz instabilitesi nedeniyle cerrahi tedavi uygulanan 23 hastadan son kontrolleri yapilan 20 hasta (17 erkek, 3 kadin) calismaya dahil edildi. Hastalarin 10’una (ort. yas 30, dagilim 17-43) acik Bankart tamiri, 10’una (ort. yas 21, dagilim 18-49) artroskopik Bankart tamiri uygulandi. Agri degerlendirmesi vizuel analog skalasina (VAS) gore yapilirken klinik sonuclar Rowe skalasi kullanilarak degerlendirildi. Ameliyat sonrasi ortalama takip suresi acik tamir grubunda 37.4±27.1 ay iken, artroskopik tamir grubunda 23±6.9 ay idi. Istatistiksel degerlendirmede Shapiro-Wilk testi ile Mann-Whitney U testi kullanildi. Bulgular: VAS skoru acik tamir grubunda 5.7±2.5, artroskopik tamir grubunda 4.1±1.9, Rowe skoru acik tamir grubunda 97.5 (dagilim 80-100), artroskopik tamir grubunda 95 (dagilim 50-100) olarak bulundu. Klinik sonuclar acik tamir grubunda 9 hastada (%90) mukemmel, bir hastada (10%) iyi iken, artroskopik tamir grubunda 8 hastada (80%) mukemmel, bir hastada (10%) iyi, bir hastada (10%) kotu olarak bulundu. Acik grupta 2 hastada, artroskopik grupta ise 5 hastada dis rotasyon kisitliligi gozlendi. Iki grup arasinda VAS skoru, Rowe skoru ve eklem hareket acikligi bakimindan istatistiksel olarak anlamli fark gorulmedi (p>0.05). Sonuc: Calismamizda artroskopik tamir ile acik tamir sonuclari, son yillardaki calismalarla paralel olarak esdeger bulundu. Ancak artroskopik tamirin cerrahi tecrube ve tamir yontemlerinin gelismesiyle, postoperatif hasta konforu ve rehabilitasyon kolayligi nedeniyle avantajli oldugu kanisindayiz. Anahtar Sozcu¨kler: Bankart; Instabilite; Omuz; Cerrahi; Acik; Artroskopi ABSTRACT Objective: The purpose of the study was to compare the clinical results of open and arthroscopic bankart repair in the surgical treatment of traumatic anterior shoulder instability. Material and Methods: Out of 23 patients who had surgical treatment due to recurrent anterior shoulder instability between January 2005 and January 2013, 20 patients (17 men, 3 women) whose last controls were made were included in the study. Open Bankart repair was applied on 10 (average age 30, ranging between 17 and 43) patients and arthroscopic Bankart repair was applied on 10 (average age 21, ranging between 18 and 49) patients. While pain was assessed according to visual analog scale (VAS), clinical results were assessed by using Rowe scale. Average postoperation follow-up time was 37.4±27.1 months in the open repair group, while it was 23±6.9 months in the arthroscopic repair group. Shapiro- Wilk test and Mann-Whitney U test were used for statistical analysis. Results: VAS score was 5.7±2.5 in the open surgery group, while it was 4.1±1.9 in the arthroscopic group and Rowe score was 97.5 (ranging between 80 and 100), while it was 95 (ranging between 50 and 100) in the arthroscopic repair group. Clinical results were perfect in 9 (90%) patients in the open surgery group, while they were good in 1 (10%) patient. In the arthroscopic repair group, clinical results were perfect in 8 (80%) patients, good in 1 (10%) patient and bad in 1 (10%) patient. Limitation of external rotation was seen in 2 patients in the open group and in 5 patients in the arthroscopic group. No statistical difference was found between the two groups in terms of VAS score, Rowe score and range of motion (p>0.05). Conclusion: The results of arthroscopic repair and open repair in our study were found to be in parallel with the results of recent studies. However, with the developments in repair methods and surgical experiences, we are of the opinion that arthroscopic repair is more advantageous due to postoperative patient comfort and ease of rehabilitation. Keywords: Bankart; Instability; Shoulder; Surgery; Open; Arthroscopy