広範囲腱板断裂に対する筋前進術を併用した鏡視下腱板修復術

概要

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Arthroscopic surgical procedures for retracted massive rotator cuff tear are debridement, partial repair and patch grafting. We developed a new arthroscopic rotator cuff repair technique combined with arthroscope assisted muscle advancement. The purpose of this prospective study was to evaluate the short clinical results of this procedure. 7 shoulders in 6 patients with massive rotator cuff tear underwent the procedure. The mean age at operation was 67.6 years old and the mean follow-up period was 15.7months. A short skin incision was made on the scapular spine. After endoscopic release of the suprascapular nerve at the suprascapular notch, medial detachment and advancement of the supraspinatus and infraspinatus muscle was performed. The torn cuff was repaired by arthroscopic procedures. We evaluated the clinical results by JOA score. The cuff repair integrity was evaluated by Sugayas MR criteria. The average final follow-up JOA score was 86.4 points. Postopearative MR imaging showed type II in 3 cases, type III in 1 case, typeV in 3 cases. Arthroscopic rotator cuff repair combined with arthroscope assisted muscle advancement provides satisfactory clinical outcomes. This procedure is considered to be one of the new arthroscopic surgical techniques for massive rotator cuff tear.
2010-08-04