Subscribe to RSS
Download PDF
DOI: 10.1055/s-0039-3402469
Artroplastia de ombro: tenotomia do subescapular versus osteotomia do tubérculo menor
Article in several languages: português | English
Resumo
Objetivo Avaliar e comparar a função do músculo subescapular entre os grupos submetidos a tenotomia do subescapular (Grupo A) e osteotomia do tubérculo menor (Grupo B), em pacientes tratados por artroplastia anatômica total e parcial de ombros apresentando osteoartrose primária.
Métodos Estudo retrospectivo de pacientes portadores de osteoartrose primária glenoumeral tratados cirurgicamente com prótese anatômica total ou parcial de ombro, avaliados por exame clínico, exames de imagens, escala visual analógica de dor e escore funcional de Constant e Murley. Foram avaliados 28 pacientes, totalizando uma amostra de 32 ombros operados. O seguimento mínimo foi de 12 meses (média 47,45 meses).
Resultados Nos pacientes submetidos à tenotomia do tendão subescapular, dez obtiveram resultado ultrassonográfico com ruptura de sua espessura total (56%). A consolidação ocorreu em todos pacientes submetidos a osteotomia do tubérculo menor. Não houve diferença entre os grupos na comparação do teste Lift Off, da força nos testes Belly Press e Bear hug, e no escore de Constant e Murley.
Conclusões Não encontramos diferença entre os grupos A e B na comparação do teste Lift Off, da força nos testes Belly Press e Bear hug, e no escore de Constant e Murley.
Publication History
Received: 10 April 2018
Accepted: 12 February 2019
Article published online:
29 May 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações
Ltda
Rio de Janeiro, Brazil
-
Referências
- 1 Cofield RH. Total shoulder arthroplasty with the Neer prosthesis. J Bone Joint Surg Am 1984; 66 (06) 899-906
- 2 Caplan JL, Whitfield B, Neviaser RJ. Subscapularis function after primary tendon to tendon repair in patients after replacement arthroplasty of the shoulder. J Shoulder Elbow Surg 2009; 18 (02) 193-196 , discussion 197–198
- 3 Miller SL, Hazrati Y, Klepps S, Chiang A, Flatow EL. Loss of subscapularis function after total shoulder replacement: A seldom recognized problem. J Shoulder Elbow Surg 2003; 12 (01) 29-34
- 4 Miller BS, Joseph TA, Noonan TJ, Horan MP, Hawkins RJ. Rupture of the subscapularis tendon after shoulder arthroplasty: diagnosis, treatment, and outcome. J Shoulder Elbow Surg 2005; 14 (05) 492-496
- 5 Gerber C, Yian EH, Pfirrmann CA, Zumstein MA, Werner CM. Subscapularis muscle function and structure after total shoulder replacement with lesser tuberosity osteotomy and repair. J Bone Joint Surg Am 2005; 87 (08) 1739-1745
- 6 Van den Berghe GR, Nguyen B, Patil S. , et al. A biomechanical evaluation of three surgical techniques for subscapularis repair. J Shoulder Elbow Surg 2008; 17 (01) 156-161
- 7 Schrock JB, Kraeutler MJ, Houck DA, Provenzano GG, McCarty EC, Bravman JT. Lesser tuberosity osteotomy and subscapularis tenotomy repair techniques during total shoulder arthroplasty: A meta-analysis of cadaveric studies. Clin Biomech (Bristol, Avon) 2016; 40: 33-36
- 8 Louie PK, Levy DM, Bach Jr BR, Nicholson GP, Romeo AA. Subscapularis Tenotomy Versus Lesser Tuberosity Osteotomy for Total Shoulder Arthroplasty: A Systematic Review. Am J Orthop 2017; 46 (02) E131-E138
- 9 Choate WS, Kwapisz A, Momaya AM, Hawkins RJ, Tokish JM. Outcomes for subscapularis management techniques in shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg 2018; 27 (02) 363-370
- 10 Gerber C, Pennington SD, Yian EH, Pfirrmann CA, Werner CM, Zumstein MA. Lesser tuberosity osteotomy for total shoulder arthroplasty. Surgical technique. J Bone Joint Surg Am 2006; 88 (Suppl 1 Pt 2): 170-177
- 11 Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986; 27 (01) 117-126
- 12 Constant CR, Gerber C, Emery RJ, Søjbjerg JO, Gohlke F, Boileau P. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg 2008; 17 (02) 355-361
- 13 Gerber C, Krushell RJ. Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases. J Bone Joint Surg Br 1991; 73 (03) 389-394
- 14 Gerber C, Hersche O, Farron A. Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am 1996; 78 (07) 1015-1023
- 15 Barth JR, Burkhart SS, De Beer JF. The bear-hug test: a new and sensitive test for diagnosing a subscapularis tear. Arthroscopy 2006; 22 (10) 1076-1084
- 16 Cohen J. A power primer. Psychol Bull 1992; 112 (01) 155-159
- 17 Walch G, Boileau P, Noël E. Shoulder arthroplasty: evolving techniques and indications. Joint Bone Spine 2010; 77 (06) 501-505
- 18 Shafritz AB, Fitzgerald MG, Beynnon BD, DeSarno MJ. Lift-off Test Results After Lesser Tuberosity Osteotomy Versus Subscapularis Peel in Primary Total Shoulder Arthroplasty. J Am Acad Orthop Surg 2017; 25 (04) 304-313
- 19 Jandhyala S, Unnithan A, Hughes S, Hong T. Subscapularis tenotomy versus lesser tuberosity osteotomy during total shoulder replacement: a comparison of patient outcomes. J Shoulder Elbow Surg 2011; 20 (07) 1102-1107
- 20 Scalise JJ, Ciccone J, Iannotti JP. Clinical, radiographic, and ultrasonographic comparison of subscapularis tenotomy and lesser tuberosity osteotomy for total shoulder arthroplasty. J Bone Joint Surg Am 2010; 92 (07) 1627-1634
- 21 Buckley T, Miller R, Nicandri G, Lewis R, Voloshin I. Analysis of subscapularis integrity and function after lesser tuberosity osteotomy versus subscapularis tenotomy in total shoulder arthroplasty using ultrasound and validated clinical outcome measures. J Shoulder Elbow Surg 2014; 23 (09) 1309-1317
- 22 Liem D, Kleeschulte K, Dedy N, Schulte TL, Steinbeck J, Marquardt B. Subscapularis function after transosseous repair in shoulder arthroplasty: transosseous subscapularis repair in shoulder arthroplasty. J Shoulder Elbow Surg 2012; 21 (10) 1322-1327
- 23 Qureshi S, Hsiao A, Klug RA, Lee E, Braman J, Flatow EL. Subscapularis function after total shoulder replacement: results with lesser tuberosity osteotomy. J Shoulder Elbow Surg 2008; 17 (01) 68-72
- 24 Itoi E, Minagawa H, Yamamoto N, Seki N, Abe H. Are pain location and physical examinations useful in locating a tear site of the rotator cuff?. Am J Sports Med 2006; 34 (02) 256-264
- 25 Leroux JL, Thomas E, Bonnel F, Blotman F. Diagnostic value of clinical tests for shoulder impingement syndrome. Rev Rhum Engl Ed 1995; 62 (06) 423-428