Resultados do reparo artroscópico do primeiro episódio de luxação glenoumeral em atletas
Arquivos
Data
2017-12-08
Autores
Terra, Bernardo Barcellos 
Orientadores
Ejnisman, Benno
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A articulação glenoumeral é caraterizada pelo amplo grau de movimento e consequentemente é a articulação mais suscetível a luxações. Considerando a alta taxa de recorrência, retorno ao esporte e a artropatia pós instabilidade, diversos autores advogam o tratamento cirúrgico após o primeiro episódio de luxação, obtendo assim um reparo mais anatômico e com um risco menor de recorrência. Há uma escassez de estudos com atletas jovens e primeiro episódio de luxação do ombro. Objetivo: Relatar os resultados do tratamento cirúrgico artroscópico após o primeiro episódio de luxação glenoumeral em atletas jovens. Método: Trata-se de um estudo retrospectivo com dados coletados de forma prospectiva de 53 pacientes (54 ombros) menores que 40 anos operados com um tempo médio entre o primeiro episódio de luxação e o ato cirúrgico de 59 dias (2-360 dias). O seguimento mínimo foi de 2 anos com uma média de 844 dias. A análise estatística foi realizada pelo software SPSS versão 20. O nível de significância utilizado foi de de alfa menor que 0,05. Resultados: A idade média dos atletas foi de 30,8 anos. A média do EROE foi de 93,8, sendo 98% de resultados bons e excelentes. Quanto ao escore de Rowe, 98,2% tiveram resultados bons e excelentes, com uma média de 95. A escala visual analógica de dor teve uma média menor que 1. A taxa de reincidência da luxação foi de 2% (um caso). Não existiu correlação entre o tempo para a cirurgia após a lesão com o resultado cirúrgico [EROE total (p = 0,16), Rowe total (p = 0,13)] e EVA (p = 0.68). Foi observado uma diferença significativa entre retorno ao esporte e resultado cirúrgico, escore EROE (p = 0,001) e Rowe total (p = 0,008). A taxa de retorno ao esporte foi de 83%, sendo que os pacientes com lesão labial superior associada tiveram menores taxas de retorno ao esporte (p = 0,001) e dos escores EROE (p = 0,017) e Rowe (p = 0,019). Conclusão: O presente estudo mostrou resultados favoráveis no tratamento cirúrgico artroscópico após o primeiro episódio de luxação em atletas jovens, sendo uma forma de tratamento eficaz e segura nesta população. O tempo de espera para a cirurgia e idade não mostraram diferença nos resultados dos escores funcionais.
Introduction: The glenohumeral joint is characterized by the large degree of movement and consequently is a joint more susceptible to dislocations. Considering a high rate of recurrence, return to the sport and an instability arthropathy, several authors advocate surgical treatment after the first dislocation episode, thus obtaining a more anatomical repair and with a lower risk of recurrence. There is a lack of studies with young athletes and the first episode of shoulder dislocation. Objective: To report the results of the arthroscopic surgical treatment after the first episode of glenohumeral dislocation in young athletes. Method: This is a retrospective study with prospectively collected data on 53 patients (54 shoulders) younger than 40 years of age operated with a mean time between the first dislocation episode and the surgical procedure of 59-days (2- 360 days). The minimum follow-up was 2 years with an average of 844 days. Statistical analysis was performed using SPSS software version 20. The level of significance was alpha of less than 0.05. Results: The mean EROE was 93.8, with 98% of good and excellent results. In the Rowe score, 98.2% had good and excellent results, with a mean of 95. The visual analog pain scale had an average of less than 1. The rate of recurrence of dislocation was 2% (one case). There was no correlation between time to surgery after injury with surgical outcomes [total EROE (p = 0.16), total Rowe (p = 0.13)] and VAS (p = 0.68). A significant difference was observed between return to sports and surgical outcome, EROE score (p = 0.001) and Rowe score (p = 0.008). The rate of return to sports was 83%, and patients with associated superior labral lesions had lower rates of return to sports (p = 0.001) and EROE (p = 0.017) and Rowe scores (p = 0.019). Conclusion: The present study showed favorable results in the arthroscopic surgical treatment after the first dislocation episode in young athletes, being a form of effective and safe treatment in this population. Waiting time for surgery and age did not show any difference in the results of functional scores.
Introduction: The glenohumeral joint is characterized by the large degree of movement and consequently is a joint more susceptible to dislocations. Considering a high rate of recurrence, return to the sport and an instability arthropathy, several authors advocate surgical treatment after the first dislocation episode, thus obtaining a more anatomical repair and with a lower risk of recurrence. There is a lack of studies with young athletes and the first episode of shoulder dislocation. Objective: To report the results of the arthroscopic surgical treatment after the first episode of glenohumeral dislocation in young athletes. Method: This is a retrospective study with prospectively collected data on 53 patients (54 shoulders) younger than 40 years of age operated with a mean time between the first dislocation episode and the surgical procedure of 59-days (2- 360 days). The minimum follow-up was 2 years with an average of 844 days. Statistical analysis was performed using SPSS software version 20. The level of significance was alpha of less than 0.05. Results: The mean EROE was 93.8, with 98% of good and excellent results. In the Rowe score, 98.2% had good and excellent results, with a mean of 95. The visual analog pain scale had an average of less than 1. The rate of recurrence of dislocation was 2% (one case). There was no correlation between time to surgery after injury with surgical outcomes [total EROE (p = 0.16), total Rowe (p = 0.13)] and VAS (p = 0.68). A significant difference was observed between return to sports and surgical outcome, EROE score (p = 0.001) and Rowe score (p = 0.008). The rate of return to sports was 83%, and patients with associated superior labral lesions had lower rates of return to sports (p = 0.001) and EROE (p = 0.017) and Rowe scores (p = 0.019). Conclusion: The present study showed favorable results in the arthroscopic surgical treatment after the first dislocation episode in young athletes, being a form of effective and safe treatment in this population. Waiting time for surgery and age did not show any difference in the results of functional scores.
Descrição
Citação
TERRA, Bernardo Barcellos. Resultados do reparo artroscópico do primeiro episódio de luxação glenoumeral em atletas. São Paulo, 2017. [65] p. Dissertação (Mestrado em Ciências da saúde aplicada ao esporte e à atividade física) - Instituto de Saúde e Sociedade (ISS), Universidade Federal de São Paulo (UNIFESP), Santos, 2017.