Comparison of Treatment Outcomes After Arthroscopic Repair and Biceps Tenotomy in Patients with Isolated Slap Lesions [Tepecik Eğit Hast Derg]
Tepecik Eğit Hast Derg. 2021; 31(2): 224-229 | DOI: 10.5222/terh.2021.83435  

Comparison of Treatment Outcomes After Arthroscopic Repair and Biceps Tenotomy in Patients with Isolated Slap Lesions

Vahit Yıldız
Adnan Menderes University Medical School, Department Of Orthopaedic And Traumatology, Aydin, Turkey

Objective: We compared the clinical outcomes after arthroscopic repair to those after biceps tenotomy in patients with isolated superior labrum anterior posterior (SLAP) Type 2-3 lesions.
Methods: A total of 48 patients with isolated SLAP Type 2-3 lesions, who underwent either arthroscopic repair (n=024) or tenotomy (n=24) were included in the study. CONSTANT shoulder scores in the postoperative 40th month were compared between both groups. Tenotomy was performed for the second time in 6 patients who did not benefit from arthroscopic repair, and their CONSTANT scores estimated before and 12 months after tenotomy were compared.
Results: The clinical outcomes were evaluated in the arthroscopic repair group. Preoperative and postoperative CONSTANT scores were 43.87 (8.32), and 71.41 (9.75) (p<0. 001), respectively. In the tenotomy group pre-, and postoperative CONSTANT scores were 40.25(8.63), and 90.04 (4.04) (p<0.001), respectively. There was not a significant difference between the two groups in terms of the preoperative scores (p=0.146), however, the comparison of the postoperative scores revealed a significant difference (p<0.001). The mean CONSTANT score was 50.3 (±5.64) at the end of 27th month, and the mean postoperative CONSTANT score was 86.8 (±7.16) at the 12th month in six patients whose complaints did not resolve and underwent repeat arthroscopic tenotomy (p<0.001).
Conclusion: In our opinion, there is no criterion for repair or tenotomy in isolated SLAP lesions. In these patients, tenotomy may be preferred in the first place because it results in more favourable outcomes compared to repair. The cause of the pain that persists after repair of the SLAP lesion should not be considered as an incorrect, inadequate repair or a complication. In the first place, intolerable biceps tendinitis should be considered.

Keywords: SLAP lesion, Repair, Tenotomy


SLAP Lezyonlu Hastalarda Artroskopik Onarım ile Biseps Tenotomi Tedavi Sonuçlarının Karşılaştırılması

Vahit Yıldız
Adnan Menderes Üniversitesi Tıp Fakültesi.ortopedi Ve Travmatoloji Ana Bilim Dalı,aydın

Amaç: İzole Süperior Labrum Anterior Posterior (SLAP) Tip 2-3 lezyonlu hastalarda artroskopik onarım ile biseps tenotomisinin klinik sonuçlarını karşılaştırmayı amaçladık.
Yöntem: İzole SLAP Tip 2-3 lezyonlu artroskopik onarım (24) ve tenotomi yapılan (24) toplam 48 hasta çalışmaya alındı. Ameliyat sonrası tenotomi ve onarım yapılan hastaların ortalama 40. ayda ki CONSTANT omuz skorları karşılaştırıldı. Onarımdan yarar görmeyen, ikinci kez tekrar opere edilip tenotomi yapılan 6 hastanın 12. ayda onarım sonrası ve tenotomi sonrası CONSTANT skorları karşılaştırıldı.
Bulgular: Klinik sonuçlar değerlendirildiğinde tamir grubunda preoperatif CONSTANT skoru 43,87 (8,32), postoperatif CONSTANT skoru 71,41 (9,75) (p<0,001) idi. Tenotomi grubunda preoperatif CONSTANT skoru 40,25(8,63), postoperatif CONSTANT skoru 90,04 (4,04) (p<0,001) idi. Preoperatif her iki grup birbirleriyle karşılaştırdığında anlamlı bir fark görülmezken (p=0,146), postoperatif her iki grubun karşılaştırılması anlamlı idi (p<0,001).Ortalama 27. ay sonunda CONSTANT skoru ortalama 50,3 (±5,64) olup şikayetleri geçmeyen ve tekrar artroskopik tenotomi yapılan altı hastanın 12. ayda postoperatif CONSTANT skoru ortalama 86,8 (±7,16) idi (p<0,001).
Sonuç: İzole SLAP Tip 2-3 lezyonlu olgularda tamir veya tenotomi kararını verdirecek herhangi bir kriter bulunmamaktadır. Bu olgularda onarıma göre daha iyi sonuç verdiği için ilk tercih olarak tenotomi kabul edilebilir. SLAP lezyonu onarımından sonra devam eden ağrının nedeni yanlış, yetersiz onarım ya da komplikasyon olarak kabul edilmemeli, ilk etapta mutlaka tolere edilemeyen biseps tendiniti akla gelmelidir.

Anahtar Kelimeler: SLAP Lezyonu, Onarım, Tenotomi


Vahit Yıldız. Comparison of Treatment Outcomes After Arthroscopic Repair and Biceps Tenotomy in Patients with Isolated Slap Lesions. Tepecik Eğit Hast Derg. 2021; 31(2): 224-229

Corresponding Author: Vahit Yıldız, Türkiye


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