Year 2017, Volume 1 , Issue 3, Pages 49 - 51 2017-12-10

Comparison of open acromioplasty outcomes according to approach type; anterior and lateral
Anterior ve lateral insizyon ile yapılan açık akromioplasti sonuçlarının karşılaştırılması

Kemal KAYAOKAY [1] , Cevad MİRZAZADE [2] , Levent KÜÇÜK [3] , Erhan COŞKUNOL [4]


Aim: Subacromial impingement syndrome appears to be one of the most frequent causes of shoulder pain. Acromioplasty is the surgical intervention modality where conservative treatment no longer gives effect. Even though arthroscopic techniques keep arising popularity, open acromioplasty  yet  is very often used surgery. Our main goal was to compare clinical success of anterior and lateral open techniques whether or not these techniques affect final range of motion, DASH , UCLA & CONSTANT scores

Methods: We assembled 37 regularly followed cases (26 female, 11 male ) over 18 years old, operated between 2014-2016. We then ultimately evaluated comparison among variations such as age,  sex,  dominant extremity,  postoperative follow-up time,  approach type,  operation duration,  acromion type and most recent form where CONSTANT, DASH and UCLA scores , ROM(range of motion) , developed complications were assessed. We divided cases to 2 main groups ; group1 anterior approach and group 2 lateral approach. Comparison throughout this particular study mainly went on these 2 groups.

Results: 70.3% (26 cases ) were female , 29.7% (11 cases) were male. Mean age was 57.64 ± 9.17 (avg 45-84years) . 75.6 % (28 cases ) had symptoms on dominant limb. Postoperative mean follow-up 18,49±5.37 months (avg 8-28 months). Mean operation duration was 35 minutes for group 1 and 37 minutes for group 2. No complications were presented. Patients also filled out prepared subjective survey papers at final clinical examination. Mean CONSTANT score was 88.5 for group1 and 83.57 for group 2.  Postoperative  recovery  lasted  upon  7.1 ± 3.3 weeks (avg 1-12 week) and 6.6 ± 3.9 weeks (avg 1-14 wk) in group 2. CONSTANT,  UCLA  and  DASH scores were evaluated separately and showed no significant difference in ordinary comparison,  whereas very  same CONSTANT  scores  were  put to  odds  ratio  calculator  and  presented surprising result ;  according to preoperative-postoperative comparison,  anterior  approach  was  predicted that  would  have  had  2.8  times  chance  to  show  better  results( 80< score)  than lateral approach. Same ordinary comparison was performed on UCLA and DASH scores and no significant difference was detected. Although very same odds ratio calculation for UCLA scores appeared to be 2.5 and for DASH it was 1.167. In all three assessment methods anterior approach was more recommendable approach type. Subjective assesments of the patients were as following:  14 patients determined clinically very good and good , 1 patient normal in group 1 , where 16 patients were determined very good amd good , 2 normal and 3 patients poor according to overall scoring .

Conclusion: There is no significant difference between anterior and lateral approaches according to ROM, various scorings, hospitalization duration. On the other hand, for subacromial impingement, open acromioplasty is yet highly reliable,  convenient method with short surgery time.

Amaç: Subakromiyal sıkışma sendromu omuz ağrısının en sık nedenlerinden biridir. Akromioplasti konservatif tedaviyle sonuç alınamayan hastalarda uygulanan bir tedavi yöntemidir. Artroskopik cerrahi yöntemlerin daha sık kullanılmaya başlanmasına rağmen açık akromioplasti sık uygulanan cerrahi bir yöntemdir. Çalışmamızın amacı anterior ve lateral insizyon sonrası uygulanan akromioplastinin tedavinin başarısını, hareket açıklığını ve  DASH, UCLA, Constant skorlamalarını etkileyip etkilemediğini ortaya koymaktır.

Metod: Kliniğimizde 2014-2016 yılları arasında opere edilmiş ve en düzenli takibi olan 18 yaş üzeri 37 (26 kadın , 11 erkek) olgu retrospektif olarak değerlendirildi. Hastaların değerlendirilmesinde cinsiyet, yaş, dominant ekstremite, operasyon süreleri, postop takip süreleri, akromion tipi ve son kontrollerinde Constant omuz skor, DASH skor, eklem ROM (range of motion), komplikasyon kısımlarının olduğu değerlendirme formu kullanıldı.

Bulgular: Hastaların %70.30’u (26 hasta) kadın, %29.70’i (11 hasta) erkekti. Ortalama yaşı 57.64 ± 9.17 (dağılım 45-84yaş) idi. Hastaların 28’inde (%75,6) dominant omuzda şikayetleri mevcuttu. Operasyon sonrası ortalama takip süresi 18,49±5.37 (dağılım 8-28 ay) idi. Ortalama operasyon süreleri anterior insizyon (grup 1) 35 , lateral insizyon (grup 2) 37  dakikaydı. Hastalarda herhangi bir komplikasyon saptanmadı. Hastaların postoperatif son kontrollerinde hazırlanmış form dolduruldu. Ortalama Constant skoru grup 1 de 88.50, grup 2 de 83.57 idi. Postop şikayetler grup 1 de ortalama 7,1 hafta± 3,3 (dağılım 1-12 hafta), grup 2 de  6.6 hafta± 3,9 (dağılım 1-14 hafta) devam ediyordu. Odds ratio değerine bakıldığında operasyon sonrasında anterior yaklaşımdaki 80 ve üzeri constant skorları  lateral yaklaşıma göre 2.8 kat daha fazladır. Postop ve preop DASH skorları farkları açısından anlamlı bir fark bulunmamıştır. Subjektif  değerlendirilmede grup 1 hastalarda 14 hasta çok iyi ve iyi, 1 hastada orta düzeyde başarılı, 1 hasta kötü olarak değerlendirildi. Grup 2 hastalarda 16 hasta çok iyi ve iyi, 2 hasta orta düzeyde başarılı, 3 hasta kötü olarak değerlendirildi.

Sonuç: Açık akromioplastide uygulanan anterior ve lateral insizyonlar sonrasında abduksiyon ve fleksiyon hareketlerinin açıklığı, skorlamalar , hastanede kalış süreleri arasında fark bulunmamaktadır. Açık akromioplasti subakromiyal sıkışma sendromunda başarı oranı yüksek, operasyon süresi kısa, pratik bir yöntemdir. 

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Subjects Surgery
Journal Section Research article
Authors

Author: Kemal KAYAOKAY
Country: Turkey


Author: Cevad MİRZAZADE

Author: Levent KÜÇÜK

Author: Erhan COŞKUNOL

Dates

Publication Date : December 10, 2017

Bibtex @research article { josam351717, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2017}, volume = {1}, pages = {49 - 51}, doi = {10.28982/josam.351717}, title = {Comparison of open acromioplasty outcomes according to approach type; anterior and lateral}, key = {cite}, author = {Kayaokay, Kemal and Mi̇rzazade, Cevad and Küçük, Levent and Coşkunol, Erhan} }
APA Kayaokay, K , Mi̇rzazade, C , Küçük, L , Coşkunol, E . (2017). Comparison of open acromioplasty outcomes according to approach type; anterior and lateral . Journal of Surgery and Medicine , 1 (3) , 49-51 . DOI: 10.28982/josam.351717
MLA Kayaokay, K , Mi̇rzazade, C , Küçük, L , Coşkunol, E . "Comparison of open acromioplasty outcomes according to approach type; anterior and lateral" . Journal of Surgery and Medicine 1 (2017 ): 49-51 <http://jsurgmed.com/en/pub/issue/31351/351717>
Chicago Kayaokay, K , Mi̇rzazade, C , Küçük, L , Coşkunol, E . "Comparison of open acromioplasty outcomes according to approach type; anterior and lateral". Journal of Surgery and Medicine 1 (2017 ): 49-51
RIS TY - JOUR T1 - Comparison of open acromioplasty outcomes according to approach type; anterior and lateral AU - Kemal Kayaokay , Cevad Mi̇rzazade , Levent Küçük , Erhan Coşkunol Y1 - 2017 PY - 2017 N1 - doi: 10.28982/josam.351717 DO - 10.28982/josam.351717 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 49 EP - 51 VL - 1 IS - 3 SN - -2602-2079 M3 - doi: 10.28982/josam.351717 UR - https://doi.org/10.28982/josam.351717 Y2 - 2017 ER -
EndNote %0 Journal of Surgery and Medicine Comparison of open acromioplasty outcomes according to approach type; anterior and lateral %A Kemal Kayaokay , Cevad Mi̇rzazade , Levent Küçük , Erhan Coşkunol %T Comparison of open acromioplasty outcomes according to approach type; anterior and lateral %D 2017 %J Journal of Surgery and Medicine %P -2602-2079 %V 1 %N 3 %R doi: 10.28982/josam.351717 %U 10.28982/josam.351717
ISNAD Kayaokay, Kemal , Mi̇rzazade, Cevad , Küçük, Levent , Coşkunol, Erhan . "Comparison of open acromioplasty outcomes according to approach type; anterior and lateral". Journal of Surgery and Medicine 1 / 3 (December 2017): 49-51 . https://doi.org/10.28982/josam.351717
AMA Kayaokay K , Mi̇rzazade C , Küçük L , Coşkunol E . Comparison of open acromioplasty outcomes according to approach type; anterior and lateral. J Surg Med. 2017; 1(3): 49-51.
Vancouver Kayaokay K , Mi̇rzazade C , Küçük L , Coşkunol E . Comparison of open acromioplasty outcomes according to approach type; anterior and lateral. Journal of Surgery and Medicine. 2017; 1(3): 49-51.
IEEE K. Kayaokay , C. Mi̇rzazade , L. Küçük and E. Coşkunol , "Comparison of open acromioplasty outcomes according to approach type; anterior and lateral", Journal of Surgery and Medicine, vol. 1, no. 3, pp. 49-51, Dec. 2017, doi:10.28982/josam.351717