Med Bull Sisli Etfal Hosp. 2021; 55(4): 486-494 | DOI: 10.14744/SEMB.2021.12354

The Effect of Acromioplasty or Bursectomy on the Results of Arthroscopic Repair of Full Thickness Rotator Cuff Tears: Does the Acromion Type Affect These Results?

Ozgun Karakus¹, Burak Gurer², Selcuk Kilic¹, Ahmet Sinan Sari^2
1Department of Orthopedics and Traumatology, Balikesir City Hospital, Balikesir, Turkey
²Department of Orthopedics and Traumatology, Omer Halisdemir University Hospital, Nigde, Turkey

Objectives: The aim of this study was to investigate the effect of subacromial decompression on the results of full thickness rotator cuff repair applied arthroscopically. Examination was also made of the effect of acromion type on the subacromial decompression procedure in patients applied with arthroscopic rotator cuff repair.
Methods: The study included a total of 150 patients, comprising 102 (68%) females and 48 (32%) males with a full thickness rotator cuff tear repaired arthroscopically. The patients were separated into three groups of 50. Group A comprised those with acromioplasty and bursectomy applied additional to the repair. In Group B, only bursectomy was performed additional to the repair and in Group C, only rotator cuff repair was applied. Evaluation was made of the post-operative long-term pain and functional results.
Results: The mean age of the cases was 65.63±9.22 years (range, 46–86 years). The affected side was right side in 95 (63.3%) cases and left side in 55 (36.7%). No statistically significant difference was determined between the groups according to the post-operative Constant Murley and ASES scores (p>0.05). In the paired comparisons, the post-operative VAS scores of Group C were higher than those of Groups A and B (p=0.018, p=0.029, p<0.05). No statistically significant difference was determined between Group A and Group B in respect of the post-operative VAS scores (p>0.05).
Conclusion: In the arthroscopic repair of full thickness rotator cuff tears, neither acromioplasty, coracoacromial ligament loosening nor bursectomy were determined to have any positive effect on the results. Whatever the acromion type, there is no need for an additional subacromial decompression procedure after rotator cuff repair, in respect of pain and functional outcomes. Only acromial spurs should be gently removed paying attention to the coraco-acromial ligament.

Keywords: Acromion, bursitis; rotator cuff impingement; rotator cuff tears; shoulder pain.

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Tam Kat Rotator Cuff Yýrtýklarýnýn Artroskopik Tamirinde, Akromýoplastinin veya Bursektominin Sonuçlara Etkisi Nedir? Akromýon Tipi Bu Sonuçlarý Etkilemekte midir?

Ozgun Karakus¹, Burak Gurer², Selcuk Kilic¹, Ahmet Sinan Sari^2
1Balýkesir Þehir Hastanesi, Ortopedi ve Travmatoloji Bölümü, Balýkesir
²Ömer Halisdemir Üniversitesi Hastanesi, Ortopedi ve Travmatoloji Bölümü, Niðde

Amaç: Bu çalýþmada amacýmýz, artroskopik olarak yapýlan tam kat rotator cuff tamirinde, subakromýal dekompresyonun tamir sonuçlarýna etkisini araþtýrmaktýr. Ayrýca artroskopik rotatorcuf tamiri yapýlan hastalarda, akromýon tipinin, subakromýal dekompresyon prosedürüne etkisini incelemektir.
Metod: Çalýþmaya tam kat rotator cuf yýrtýðý olan ve artroskopik olarak tamir edilen %68.0’i (n=102) kadýn, %32.0’si (n=48) erkek olmak üzere toplam 150 hasta dahil edilmiþtir. Hastalar 50 þerli gruplar olmak üzere toplam 3 gruba ayrýlmýþlardýr. Grup A: tamire ek bursektomi, akromýoplasti yapýlan hastalardan oluþturulmuþtur. Grup B: Tamire ek, sadece bursektomi yapýlan hastalardan, Grup C’de ise sadece rotator cuf tamiri yapýlmýþtýr. Ameliyat sonrasý geç dönem, aðrý ve fonksiyonel sonuçlar deðerlendirilmiþtir.
Bulgular: Olgularýn yaþlarý 46 ile 86 arasýnda deðiþmekte olup, ortalama 65.63±9.22 yýldýr. Çalýþmaya vakalarýn %63.3’ünün (n=95) sað tarafý, %36.7’sinin (n=55) sol tarafý alýnmýþtýr. Tüm olgularýn postop Constant Murley ve ASES skorlarý gruplara göre istatistiksel olarak anlamlý farklýlýk göstermemektedir (p>0.05). Yapýlan ikili karþýlaþtýrmalar sonucunda; C grubunun postop VAS skorlarý, A grubu ve B grubundan daha yüksektir (p=0.018; p=0.029; p<0.05). A ve B grubunun VAS skorlarý arasýnda istatistiksel olarak anlamlý farklýlýk saptanmamýþtýr (p>0.05).
Sonuç: Tam kat rotator cuf yýrtýklarýnýn artroskopik tamirinde, ne akromýoplasti, ne Corocoakromýal bað gevþetilmesi, ne bursektominin sonuçlara pozitif bir etkisi saptanmamýþtýr. Rotatorcuf tamiri sonrasý acromion tipi ne olursa olsun ek bir subakromýal dekompresyon prosedürü uygulanmasýna aðrý ve fonksiyonel sonuç açýsýndan gerek yoktur. Sadece acromial spurlar Coracoakromýal baða dikkat ederek hafifçe alýnmalýdýr. (SETB-2021-04-106)

Anahtar Kelimeler: Rotator Manþet Yýrtýklarý, Rotator Manþet Sýkýþma, Omuz aðrýsý, Bursit, Akromion.

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