鏡視下腱板修復術における修復腱板の経時的MRI所見と臨床成績 : 単層固定法と重層固定法の比較

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Although several clinical and anatomical results after arthroscopic rotator cuff repair were reported, the longitudinal improvement of cuff integrity was not studied. The purpose of this study was to compare the morphologic improvement of repaired cuff and the functional outcome of single-row (SR) and double-row (DR) fixation after arthroscopic rotator cuff repair. A consecutive series of 131 shoulders with rotator cuff tears were evaluated using the Japanese Orthopaedic Association (JOA) shoulder index. There were 66 shoulders (55 males, 11 females, mean 59 years-old) in the SR group and 65 shoulders (47 males and 18 females, mean 61 years-old) in the DR group. Average follow-ups were 30 and 22 months, respectively. To evaluate the postoperative cuff integrity, MRIs were performed at three, 6 and 12 months postoperatively. The signal change in the repaired cuff was classified into 3 categories: Low(L), Intermediate(I) and High(H). The average JOA score improved from 62.4 to 95.0 in SR and from 62.5 to 93.3 in DR. There was no statistical difference between the groups. On MRIs (3,6,12months), the rates(%) of H were (36,27,23) in SR, (30,15,10) in DR. The rates of I were (55,27,27) in SR, (50,45,15) in DR. The rates of L were (9,46,50) in SR, (20,40,75) in DR. In both groups, H or I decreased but L increased longitudinally. At 12months, however, the rate of low signal in DR (75%) was significantly higher than in SR (50%, p=0.004). MRI findings of repaired cuff after arthroscopic rotator cuff repair revealed serial signal changes in both groups. Repaired-cuffs after DR fixation showed a faster morphologic improvement than those after SR, suggesting that the DR method is suitable for tendon-bone fixation.
日本肩関節学会の論文
2008-06-30

鏡視下腱板修復術における修復腱板の経時的MRI所見と臨床成績 : 単層固定法と重層固定法の比較

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