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    Does Preoperative Conservative Management Affect the Success of Arthroscopic Repair of Partial Rotator Cuff Tear?
    (Springer Heidelberg, 2022) Ayanoglu, Tacettin; Ozer, Mustafa; Cetinkaya, Mehmet; Kaptan, Ahmet Yigit; Ulucakoy, Coskun; Ataoglu, Baybars; Kanatli, Ulunay
    Background The aim of this study is to examine the effect of preoperative conservative treatment on the success of high-grade bursal/articular-sided partial rotator cuff repair. Methods Patients who had undergone shoulder arthroscopy in institution for Ellman Stage 3 bursal-side or articular-side partial tears between January 2008 and April 2018 were investigated retrospectively. This study assessed 201 patients diagnosed with isolated partial rotator cuff tears with a history of failed conservative management and persistent shoulder pain who underwent arthroscopic surgery. The demographic data of patients and pre- and postoperative The American Shoulder and Elbow Surgeons Shoulder Scores (ASES) that were recorded in the archive were evaluated. Results While 55 of the patients with Ellman grade 3 bursal-sided partial tears received preoperative conservative management for at least 6 months (Group 1), 62 of them could not tolerate conservative management and early arthroscopic repair was performed (Group 2). On the other hand, 42 of the patients with Ellman grade 3 articular-sided tears received preoperative conservative management (Group 3), 42 of them could not tolerate preoperative conservative management (Group 4). The mean ASES score improvement was 52.33 +/- 8.55 for Group 1, 54.68 +/- 11.29 for Group 2, 48.4 +/- 7.77 for Group 3 and 49.33 +/- 10.05 for Group 4. A statistically significant difference was found between the groups with one-way ANOVA test (p = 0.05). With the Tukey test, this difference was seen to be caused by Group 2. Conclusion Although there are many factors affecting its success, conservative management should be the first option in the treatment of partial rotator cuff tears. However, we think that it should not be insisted especially in patients with bursal-sided tears (> 50% of the tendon thickness) that cannot tolerate conservative management due to severe pain since the results of early arthroscopic repair of bursal-sided tears were found to be better.
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    Effect of the presence of cysts in the hip joint on hip arthroscopy
    (Turkish Joint Diseases Foundation, 2024) Ciceklidag, Murat; Ayanoglu, Tacettin; Kaptan, Ahmet Yigit; Vural, Abdurrahman; Kalaycioglu, Oya; Ozer, Mustafa; Kanatli, Ulunay
    Objectives: The aim of this study was to investigate whether the presence and size of fibrous cysts affected postoperative results in patients undergoing hip arthroscopy. Patients and methods: Between January 2010 and December 2019, a total of 261 patients (138 males, 123 females; mean age: 39.5 +/- 11.9 years; range, 18 to 66 years) who underwent hip arthroscopy with the diagnosis of cam-pincer-mixed-type femoroacetabular impingement (FAI) and labral pathologies were retrospectively analyzed. The study groups (impingements and labral pathologies) and the presence of cyst (or cyst size: <5 mm, 5-8 mm, >8 mm) were used as the fixed effects, and the analysis was adjusted for baseline age, sex, and preoperative scores. Pre- and postoperative modified Harris Hip Score (mHHS) and Visual Analog Scale (VAS) scores that were applied to all patients were used as an indication of clinical results. Results: The mean preoperative mHHS score of the patients with a cyst was significantly lower compared to the patients without a cyst (56.8 +/- 12.3 vs. 60.3 +/- 12.7, p=0.026). The mean change in the mHHS score and the mean percentage change in VAS score were significantly higher in the patients with a cyst compared to the patients without a cyst (mHHS score: 28.1 +/- 14.0 vs. 22.5 +/- 14.1, p=0.002; VAS score: 61.9 +/- 30.2 vs. 52.6 +/- 47.4, p=0.038). The increase in mHHS score over time for patients with a cyst was significantly higher than the patients without cysts in the pincer group (38.1 +/- 11.1 vs. 19.3 +/- 13.5, p<0.001). The patients with a cyst size of >8 mm had a significantly higher increase in the mHHS scores compared to the patients with a cyst size of <5 mm (29.5 +/- 12.9 vs. 23.5 +/- 13.8, p=0.043). Conclusion: Subchondral cysts in the femoral head and neck junction accompanied cam-type and mixed-type FAI, while subchondral cysts in the acetabulum accompanied pincer-type impingement. In all groups, the mean increase in mHHS scores and the mean decrease in VAS scores were higher in patients with subchondral cysts than in patients without cysts. In patients with subchondral cysts, if the lesion causing FAI is treated arthroscopically, it can positively affect the functional results.