鏡視下腱板修復術後の筋力と筋横断面積の経時的変化の検討
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The purpose of this study was to evaluate the changes with time of the muscle strength of the shoulder and the cross-sectional area ( CSA ) of rotator cuff muscle after arthroscopic rotator cuff repair ( ARCR ) and to investigate the relationship between the tear size of rotator cuff and the muscle strength and CSA before ARCR. We investigated 20 cases ( 13 males and 7 females ). The mean age at operation was 63.5 years old ( 54 - 78 ). Pre and post - operative muscle strength and CSA were compared at 6 months and 1 year after the operation. We measured the longest anterior posterior diameter ( a ) and the longest transverse diameter ( b ) among the findings at the operation.11 cases were S size classified in a ≤ 2cm and b ≤ 2cm, 9 cases were L size classified in a > 2cm and b > 2cm. We performed 3 tests as abduction, 2 tests as external rotation and internal rotation. We evaluated the isometric muscle strength of the shoulder using MICROFET. Some physical therapists did these tests 3 times and the results were averaged.The results were divided by the value of the pre-operative unaffected side. We measured the CSA of supraspinatus, infraspinatus, teres minor and subscapilaris at a slice 1cm medial to the gleno-humeral joint with an MRI oblique-sagittal view of T2.We used the values that divided the CSA by the head of the humerus area to eliminate any individual difference.The muscle strength gradually recovered after operation regardless of tear size.The strength of external rotation showed statistically significant changes at 6 months after the operation.The strength of abduction and internal rotation showed a meaningful recovery 1 year after the operation.On the other hand, the CSA did not show any significant changes after the operation.The pre-operative muscle strength of abduction and external rotation were significantly correlated with the tear size.
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