大・広範囲腱板断裂に対する Debeyre-Patte 変法の短期治療とその手術適応

概要

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The treatment for massive rotator cuff tear is difficult. We investigated the pre-, intra, and postoperative evaluation for the torn cuff to improve the clinical results for this disorder. 8 shoulders in 8 patients with large and massive rotator cuff tear were examined in this study. The mean age at the operation was 60.8 years old, and the mean follow-up periods were 14.1months. During operation, the torn cuff was hooked by suture and the tensile strength was measured. After arthroscopic release of supraspinatus and infraspinatus, medial detachment and advancement of the supraspinatus and infraspinatus muscle were performed. The torn cuff was repaired by suture-reel technique within 20N tensile strength. We evaluated the clinical results by JOA score. The repaired cuff integrity was evaluated by MR criteria. The mean tensile strength was over 40N at the edge of torn cuff. The average postoperative JOA score was 86.2 points. Postoperative MR imaging showed type I in 4 cases, type II in 2 cases, type III in 1 case, type V in 1 case. The short term clinical results in this study seemed to be sufficient. To improve the clinical results of large and massive rotator cuff tear, the evaluation of pre-, and intraoperative torn cuff is considered to be important.
2010-08-04