腱板広範囲断裂に対する大腿筋膜パッチ法術後肩筋力評価と術後成績

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Fascia lata patch grafting is one of the possible methods for repair of a massive rotator cuff tear for which we are unable to perform a primary suture. However, some researchers have indicated that shoulder muscle power recovery of such cases is not always adequate. So we evaluated muscle power and postoperative results of the fascia lata patch grafting method for massive rotator cuff tear, as there is few precise reports elucidating muscle power recovery, though. The cases were 12 patients (9 males and 3 females) with a primary massive rotator cuff tear who underwent fascia lata patch grafting. The age on average was 60.9 years old at the time of surgery. They were followed up for over 2 years postoperatively (34 months on average), and could be examined directly in our offices at the last time we saw them. The results were evaluated using the Japanese Japan Orthopaedic Association (JOA) score and it significantly improved from 67.0 to 89.5. Isometric muscle power was measured with MicroFET. Shoulder abduction strength significantly improved from 18.5 to 75.8 N at 45 degrees of abduction, from 14.2 to 55.4 N at 90 degrees of abduction. External rotation strength significantly improved from 19.9 to 53.7 N. Internal rotation strength improved from 77.2 to 122.4 N, but it was not significant. The external rotation strength did not recover well compared with that of abduction. This may be because a massive rotator cuff tear often includes infraspinatus muscle atrophy and fatty degeneration, so that it is fundamentally difficult to recover external rotation strength. We concluded that fascia lata patch grafting is an effective method for repair of massive rotator cuff tear and both abduction and external rotation strength can significantly recover, but we should do something more to improve the extent of the external rotation strength recovery.
日本肩関節学会の論文

腱板広範囲断裂に対する大腿筋膜パッチ法術後肩筋力評価と術後成績

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