RESUMO
BACKGROUND: One of the currently used surgical techniques in isolated type II SLAP lesions is arthroscopic SLAP repair. Postoperatively, patients tend to suffer from a prolonged period of pain and are restricted in their sports activities for at least 6 months. The aim of this study was to prospectively evaluate the clinical outcome as well as the postoperative course of pain after arthroscopic type II SLAP repair. METHODS: Outcome measures were assessed using the Individual Relative Constant Score (CSindiv), the American Shoulder and Elbow Surgeons (ASES) Score, the Visual Analogue Scale (VAS), and the Short Form 36 (SF-36). Data were collected preoperatively, as well as at 3, 6, 12 and >24 months postoperatively. RESULTS: Eleven patients with an average age of 31.8 years (range: 22.8-49.8 years) underwent arthroscopic repair of isolated type II SLAP lesions. Mean follow-up time was 41.9 months (range: 36.1-48.4 months). 6 months after surgery, there was a statistically significant improvement of function according to the CSindiv (p = 0.004), the ASES Score (p = 0.006), and the SF-36 subscale "physical functioning" (p = 0.014) and a statistically significant decrease of pain according to the VAS (p = 0.007) and the SF-36 subscale "bodily pain" (p = 0.022) compared to preoperative levels. CONCLUSIONS: Arthroscopic repair of isolated type II SLAP lesions with suture anchors leads to a satisfactory functional outcome and return to pre-injury sports levels, with delayed, but significant pain relief observed 6 months after surgery. Thus, a return to sports should not be allowed earlier than 6 months after surgery, when patients have reached pain-free function and recovered strength. TRIAL REGISTRATION: Researchregistry1761 (UIN).
Assuntos
Artroscopia/efeitos adversos , Traumatismos em Atletas/cirurgia , Procedimentos Ortopédicos/efeitos adversos , Volta ao Esporte , Lesões do Ombro/cirurgia , Traumatismos dos Tendões/cirurgia , Adulto , Artroscopia/instrumentação , Artroscopia/métodos , Traumatismos em Atletas/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/instrumentação , Procedimentos Ortopédicos/métodos , Medição da Dor , Dor Pós-Operatória/etiologia , Período Pós-Operatório , Estudos Prospectivos , Amplitude de Movimento Articular , Lesões do Ombro/diagnóstico por imagem , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/fisiopatologia , Articulação do Ombro/cirurgia , Âncoras de Sutura , Traumatismos dos Tendões/diagnóstico por imagem , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: The aim of this study is to demonstrate the importance of clinical diagnosis by comparing with preoperative physical examination and magnetic resonance imaging (MRI) images in patients who were arthroscopically diagnosed as having Superior Labrum Anterior-Posterior (SLAP) II lesions. MATERIALS AND METHODS: 134 patients, arthroscopically diagnosed as SLAP II, established the study group, and 200 patients who underwent shoulder arthroscopy for the other pathologies established the control group. Preoperative clinical examination of the patients, MRI findings, and the arthroscopic findings of the patients were recorded. RESULTS: Out of the patients diagnosed with a SLAP II lesion, 107 (79.9) of those had an MRI finding while only 60 (30%) of the control group had it. The O'Brien test results of the patients diagnosed with SLAP were positive in 111 (82.8%) while those diagnosed with intact superior labrum were positive in 132 (66%). Of the 134 patients with a SLAP II lesion, 89 (66.4%) had both O'Brien test positiveness and MRI finding, and 129 (96%) had at least one positive result of the O'Brien test or MRI examination. CONCLUSION: The O'Brien test and MRI examination are not capable enough to indicate a SLAP lesion one by one, because of the low sensitivity and specificity. But, combining the test with MRI findings provides more trustable information about the superior labrum.