鏡視下腱板修復術後再断裂の MRI 像の検討：筋萎縮と脂肪変性

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We evaluated the characteristics in MRIs of the re-tear cases after ARCR and the changes of a postoperative rotator cuff at a later period. We examined 40 cases (average age 65.8 years old) on whom we performed ARCR from May 2003 to April 2007 and who had had MRIs preoperative and at 6, 12 months post operation. We classified them in two groups, the re-tear group after operation and the non re-tear group, and evaluated thepreoperative tear shape, atrophy of rotator cuff muscle belly, fat degeneration using MRIs. The fat degeneration was evaluated by Goutlliers classification. In addition, we investigated tbe postoperative changes at a later period. We diagnosed re-tear in 6 shoulders (15%) out of 40 shoulders in MRIs at a postoperative 6 months. The tear size had a tendency of enlargement. The age of either group did not have a significant difference. Preoperative rotator cuff tear size of the re-tear group was larger than of the non re-tear group in transverse and longitudinal diameters, significantly (P < 0.01). The small tendency had the cross section product of rotator cuff belly of muscle in re-tear group, but there was not the statistical significance difference. As a risk factor of a re-tear, it was thought that a preoperative rotator cuff tear being big, fatty degeneration of rotator cuff belly of muscle were strong. We conclude that the risk factors of rotator cuff re-tear are preoperative large tear, fat degeneration of the muscle belly.