広範囲腱板断裂に対する半腱様筋腱・薄筋腱移植の成績不良例の検討

概要

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Massive rotator cuff tear is very difficult to care for and postoperative results are not always good. So, we performed semitendinosus tendon and gracilis tendon graft for massive rotator cuff tear (ST • G graft). There are 25% of unsatisfactory cases, whos postoperative MRI is classified as type IV or V according to Sugayas classification. From 2002 to 2008, we performed ST • G graft on 45 cases, and 40 cases were followed over 6 months and postoperative MRI were taken. We studied the ROM of the shoulder, the shoulder score of Japanese Orthopaedic Society, the size of the rotator cuff tear, the size of the footprint, the rate of right side, rate of male and age. We used t-test and chi-test to compare statistically. There were 8 cases of Sugayas type I, 16 cases of type II, 6 cases of type III, 3 cases of type IV, and 7 cases of type V. The ratio of the footprint was calculated. We divided the width of the footprint by the width of the head of the humerus, and this ratio is statistically small in unsatisfactory cases. Risk factors of unsatisfactory results of ST • G graft for massive rotator cuff tear were “Male”, “Right side”. “Small ratio of footprint”. Modification of suture technique, operative indication, and tight control of post operative ADL will lead to good results.
2010-08-04