Surface-holding repair technique を用いて修復した腱板広範囲断裂の術後成績

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Although various surgical procedures have been reported on for rotator cuff tears, the reported re-tear rate after open, mini-open, and arthroscopic repair has ranged from 24% to 94%, as demonstrated by arthrography, ultrasonografy, and magnetic resonance imaging. Especially in massive rotator cuff tears, the clinical outcome was distinctly less satisfactory than that for patients who had a smaller tear, and repair may not always be warranted for massive tears. The recent biomechanical studies have demonstrated that the double row tendon-to-bone fixation was stronger and footprint coverage of the double row fixation was larger than the single row or transosseous fixation technique. Therefore we have devised a new suture technique without suturing on the tendon named the surface-holding repair technique. The objectives of this study were to determine whether a new repair technique of rotator cuff tendons can yield a lower re-tear rate and to obtain a better clinical outcome than previous reported methods. With regard to repair integrity of the rotator cuff at a mean of 36.8 months postoperatively, according to Sugayas classification, MRI scans revealed 14 shoulders with a type-I, four shoulders with a type-II, 4 shoulders with a type-III, 2 shoulders with a type-IV, and nothing with a type-V repair. Synthetically, 2 shoulders had a discontinuous cuff. Therefore the re-tear rate was 8.3% (2 of 24 shoulders). In conclusion, satisfactory clinical results were obtained with the surface-holding repair technique for massive rotator cuff tears. Although OA glenohumeral joint and upper migration of the humeral head, both had progressed postoperatively in some shoulders, the incidence rates were no higher than those of other procedures. In re-tear rate, the rate was lower than that of other procedures. Therefore this technique will be one of the good procedures in rotator cuff operations.
日本肩関節学会の論文
2008-06-30

Surface-holding repair technique を用いて修復した腱板広範囲断裂の術後成績

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