Omuz Artroskopisi Endikasyonları
Özet
Omuz artroskopisi, glenohumeral eklem içi ve subakromiyal patolojilerin mükemmel şekilde görüntülenmesini, teşhisini ve tedavisini sağlayan, açık cerrahiye üstünlük sunan modern bir yöntemdir. Cerrahi dışı tedavilere yanıt vermeyen şüpheli vakalarda tanısal amaçla veya bursoskopi eşliğinde rutin olarak uygulanabilir. Temel endikasyonları arasında, medikal tedaviye dirençli sekonder ve bazı primer adeziv kapsülit olguları, tenotomi veya tenodez gerektiren kronik biseps tendiniti ve akut tendon rüptürleri yer alır. Ayrıca, işlevsel bozukluğa yol açan SLAP lezyonları, adeziv kapsülitle karışabilen subakromiyal sıkışma sendromu ve ayak izinin en az yarısını içeren, konservatif tedaviye yanıtsız kısmi ya da tam kat rotator manşet yırtıkları bu yöntemle başarıyla tedavi edilir. Özellikle gençlerde sık görülen travmatik anterior çıkıklar sonucu gelişen Bankart lezyonları, eşlik eden Hill-Sachs kemik kayıpları, sporcularda görülen posterior instabilite ve eklem hipermobilitesinin eşlik ettiği çok yönlü omuz instabilitesi (ÇYOİ) durumlarında doğru hasta seçimiyle artroskopik stabilizasyon ve gevşetme prosedürleri uygulanarak cerrahi başarı elde edilir.
Shoulder arthroscopy is a modern method that provides excellent visualization, diagnosis, and treatment of glenohumeral intra-articular and subacromial pathologies, offering superiority over open surgery. It can be applied for diagnostic purposes in suspicious cases unresponsive to non-surgical treatments or routinely accompanied by bursoscopy. Its main indications include medical treatment-resistant secondary and certain primary adhesive capsulitis cases, chronic biceps tendinitis requiring tenotomy or tenodesis, and acute tendon ruptures. Additionally, functional SLAP lesions, subacromial impingement syndrome that can be confused with adhesive capsulitis, and partial or full-thickness rotator cuff tears involving at least half of the footprint and unresponsive to conservative treatment are successfully treated with this method. Especially in young individuals, Bankart lesions developing after traumatic anterior dislocations, accompanying Hill-Sachs bone losses, posterior instability seen in athletes, and multidirectional shoulder instability (MDSI) accompanied by joint hypermobility are treated with arthroscopic stabilization and release procedures through correct patient selection to achieve surgical success.
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