肩腱板広範囲断裂に対する鏡視下自家腸脛靭帯移植術の短期治療成績

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概要

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• The purpose of this study was to describe clinical outcomes, cuff integrity and shoulder muscle strength, of patch grafting using the iliotibial band for irreparable massive rotator cuff tears. We evaluated 10 shoulders in 9 patients (6 males and 3 females, average age: 67.7). The average follow-up period was 16.7 months (range: 12-21 months). One year after operation, the clinical results and cuff integrity were assessed by JOA score and Sugayas MRI classification, respectively. Preoperative and postoperative degrees of fatty degeneration were determined by Goutalliers classification. Muscle strength was measured with MicroFET at preoperation and one year after surgery. The average JOA score improved from 52.5 to 85.7 points. MRI study declared type 2 repair was seen in 5 shoulders, Type 3 repair in 2 shoulders, Type 5 in 3 shoulders. Re-tear rate was 30 percent. The average JOA score in the re-tear group was 76.5 point. The average shoulder abduction strength improved from 36.1 to 62.3 N at 45 degrees of abduction (P<0.0001), and from 31.0 to 62.3 N at 90 degrees of abduction (P<0.0001). External rotation strength improved from 25.0 to 27.4 N (P<0.05). Internal rotation improved from 76.1 to 85.4 N (P<0.0001). The external rotation strength did not recover well compared with that of abduction and internal rotation. Witout postoperative re-tear, the results of this procedure were favorable. The muscle strength improved significantly, but fatty degeneration did not. We couclude it is necessary to select this procedure, in consideration of the fatty degeneration of the infraspinatus.

• 2010-08-04

著者

• 森 大祐

  康生会 武田病院 整形外科

• 真多 俊博

  康生会 武田病院・整形外科

• 森 大祐

  医療法大財団 康生会 武田病院整形外科

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