肩甲下筋断裂を合併した広範囲腱板断裂に対する鏡視下修復術

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Although rotator cuff tears are being repaired arthroscopically with increasing frequency by orthopaedic surgeons, the arthroscopic repair of subscapularis tears remains a challenge and only few studies have examined treatment outcomes. The purpose of this study was to evaluate the outcome in patients who underwent the procedure. Our prospective study population consisted of 15 patients, 11 males and 4 females, whose mean age was 62 years old (range 52 - 69 years old). The mean duration of follow-up was 33 months (range 25 - 60 months). All had a full-thickness tear of the subscapularis tendon; 10 had a concomitant supraspinatus tear, and 5 had concomitant supraspinatus and infraspinatus tears. The shoulders were evaluated using the JOA score. An arthroscopic suture anchor technique was used for the repair. After arthroscopic repair, the mean JOA scores significantly improved from 54.4 points to 90.1 points (p<0.0001). Rated on the JOA scale, the outcomes were excellent in 8 patients, good in 5, fair in 1, and poor in 1. Preoperatively, 12 patients had a positive- and 1 a negative lift-off test; 2 patients could not be tested as they had a restricted range of internal rotation. The belly-press test was positive in 14 and negative in 1 patient. Postoperatively, 3 patients had a positive and 12 a negative lift-off test; 4 had a positive and 11 a negative belly-press test. Arthroscopic repair of subscapularis tears using the suture anchor technique is a safe and effective procedure with respect to the alleviation of shoulder pain and the improvement of function and range of motion.
日本肩関節学会の論文

肩甲下筋断裂を合併した広範囲腱板断裂に対する鏡視下修復術

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