COMPARATIVE STUDY OF LASER ASSISTED SUBACROMIAL DECOMPRESSION AND DECOMPRESSION PERFORMED CONVENTIONALLY
Authors:
Libor Čech; Rudolf Ditmar; Aleš Spáčil
Authors place of work:
Klinika ortopedické chirurgie FN Olomouc
; Department of Orthopaedic Surgery
; Faculty Hospital and Medicine Faculty of the Palacky University Olomouc
Published in the journal:
Úraz chir. 13., 2005, č.4
Summary
Purpose of the study:
The authors performed a comparison study on a group of patients who underwent arthroscopic subacromial decompression (ASD) of both shoulders. One shoulder was operated conventionally with mechanical tools and the other using laser. The aim of the study was to compare the results after surgery and evaluate which method provides better outcomes for the patient.
Material:
A group of 40 patients with II. stage of impingement syndrome of both shoulders was investigated. The average age of patients was 52 years. All underwent unsuccesful conservative therapy (which takes minimally 6 months) and none had any associated intraarticular diagnosis.
Methods:
All patients were operated under general anesthesia by the first author. Conventional decompression included: bursectomy with shaver, acromioplasty with bone burr, discision of the coracoacromial ligament by punch. Laser assisted decompression included: bursectomy with shaver, acromioplasty with bone burr, discision of the coracoacromial ligament by laser. All laser assisted surgeries were performed with 2.1 μm Holmium: YAG laser Sharplan 2040 with power output 2.5W – 40W. No multiple intraarticular procedure was performed at the same time. The results were measured by UCLA shoulder rating scale.
Results:
In the laser treated group satisfactory results increased by 10 % and excellent results increased by 15 %. No poor result was recorded.
Discussion:
The use of laser is advantageous in arthroscopic surgery where postoperative bleeding has a substantial influence on satisfactory results. Discision of coracoacromial ligament by laser reduces postoperative bleeding, followed by pain reduction and shortened recovery time. These factors result in better outcomes measured by UCLA shoulder rating scale.
Conclusion:
Arthroscopic subacromial decompression with the assistence of 2.1 μm Holmium: YAG laser provides more benefits than conventionally performed decompression.
Key words:
impingement syndrome, laser, subacromial decompression.
Zdroje
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