ObjectiveThe cause of anterior shoulder instability is not fully understood and surgical management remains controversial. The objective of this study was to evaluate the results of patients undergoing arthroscopic Latarjet procedure with endobuttons.MethodsA retrospective study of 26 patients undergoing arthroscopic Latarjet procedure with endobuttons to treat anterior shoulder instability. Patients with previous glenohumeral instability, failure of Bankart procedure or Instability Severity Index Score (ISIS) greater than or equal to 6, were included. Patients were assessed by: DASH, UCLA, Rowe, Visual Analog Scale (VAS) of pain and Short-Form 36 (SF36) scores. Correct position and consolidation of the graft were evaluated.ResultsMean age was 31.5 years (16 to 46). Preoperative duration of symptoms was 1.7 years (1 month to 10 years). Mean follow-up was 14.3 (6 to 24) months. Mean postoperative scores were: 10 points in DASH; 1.6 in VAS, where 23 (88%) patients experienced mild pain and 3 (12%) moderate pain; 89 in Rowe; 32 in UCLA and 78 in SF-36. Positioning of the graft was correct in 25 (96%) cases, and was consolidated in 23 (88%). We had two cases of graft fracture (7%) and postoperative migration (7%).ConclusionSurgical treatment using arthroscopic Latarjet with endobuttons is safe and effective, producing good functional outcomes in patients. Level of Evidence IV, Case Series.
Resumo
Objetivo Avaliar os resultados funcionais dos pacientes submetidos a artroplastia reversa de ombro, para tratamento da artropatia do manguito refratária a tratamento conservador.
Métodos Estudo retrospectivo de 20 pacientes (21 ombros), 17 mulheres (81%) e 3 homens (19%), submetidos a artroplastia reversa de ombro no período de outubro de 2012 a setembro de 2017, para tratamento de artropatia de manguito rotador, operados por um único cirurgião em um único centro. Os pacientes foram avaliados pelo escore de disfunções do braço, ombro e mão (DASH, na sigla em inglês), pelo questionário genérico de avaliação de qualidade de vida SF-36 (SF-36), pela escala visual analógica de dor (EVA) e pelo escore da Universidade de Los Angeles – Califórnia (UCLA, na sigla em inglês). A média de idade na cirurgia foi de 66 anos (variação de 55 a 83 anos). O tempo de sintomas antes da realização da cirurgia foi de ∼ 2,5 anos (variação de 12 meses a 6 anos). O seguimento médio foi de 42,4 meses (variação de 19 a 56,7 meses).
Resultados A média dos escores pós-operatórios foi de 18,2 pontos no DASH; de 2 pontos na EVA, sendo 16 (77%) de dores leves, 4 (18%) de dores moderadas e 1 (5%) de dor intensa; de 29 pontos no UCLA, sendo 6 pacientes com resultado regular (28%), 10 pacientes com resultado bom (48%), e 5 pacientes com resultado excelente (24%); e de 63 pontos no SF-36. Tivemos como complicações quatro casos de notching, um caso de fratura de acrômio por estresse, e um caso de infecção pós-operatória.
Conclusões A artroplastia reversa do ombro apresenta bons resultados funcionais nos escores avaliados, propiciando melhora significativa na qualidade de vida dos pacientes.
Objective: To evaluate the outcomes of patients that underwent arthroscopic surgery for lateral epicondylitis (LE), after failed conservative treatment. Methods: One hundred four patients with LE treated with arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon were enrolled in this retrospective study. They were evaluated using Disabilities of the Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) and Short Form Health Survey (SF-36) scale. Mean age at surgery was 46.9 years. Duration of symptoms was 2.1 years (range: 6 m to 10 yrs.). Mean follow-up was 34.4 months (range: 6 to 68 m). Results: Mean postoperative scores were: 20.67 points on the DASH; 1.8 points on the VAS at rest, with 48 cases (46%) without pain, 40 (38%) with mild pain, 13 (13%) with moderate pain and 4 (4%) with severe pain; 4.7 points on the VAS in activity, with 21 (20%) without pain, 21 (20%) with mild pain, 35 (34%) with moderate pain and 27 (26%) with severe pain; and SF-36 was 66.8 points. Of the 23 patients who practiced sports regularly or with higher physical demand from the upper limbs, 17 (74%) were able to return to the same activity at the same level. No significant complications were observed postoperatively, except for 3 (2.8%) cases of postoperative superficial infection. Conclusion: Surgical treatment with arthroscopy for recalcitrant LE is effective and safe, presenting positive outcomes in the studied patients. Level of evidence IV, Case Series.
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