鏡視下腱板修復術における術前JOAサブスコアの術後成績への影響

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The purpose of this study was to report which preoperative factors could influence on the postoperative results of arthroscopic rotator cuff repair (ARCR). A consecutive series of 52 patients with rotator cuff tears underwent ARCR and were evaluated by the scoring system of the Japanese Orthopaedic Association (JOA) pre- and post-operatively. The 52 shoulders were classified into 2 (high and low score) groups by preoperative JOA pain, or function, or ROM subscore. The 2 groups were compared by each postoperative JOA total score at 3, 6, 9 and 12 months and retear rate at 6 months. Retear rate was estimated by MRI, using Sugayas classification. The postoperative JOA score in the low function score group was less than the high score group at 3, 6 and 12 months, and had higher retear rate (33 % vs 12 %, p < 0.05). The JOA score in the low ROM group was less than the high score group at 6 and 9 months postoperatively, but had no significant difference in retear rate. There was no difference in both JOA score and retear rate between high and low pain score groups. There were higher correlation (r2 = 0.488) between preoperative function and ROM subscore because the ROM score in JOA was evaluated in active motion. So, we propose preoperative evaluation of rotator cuff tears with classification into 4 groups using a combination of JOA pain and function subscores which we regarded as independent. The group 1 (low pain and low function scores) had a lower postoperative JOA score and higher retear rate than other groups. In conclusion, preoperative JOA function subscore could influence on the postoperative clinical results of ARCR, especially when there were lower scores in both function and pain subscores.
2009-07-27

鏡視下腱板修復術における術前JOAサブスコアの術後成績への影響

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