関節鏡視下腱板修復術のラーニングカーブについて
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概要
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Arthroscopic rotator cuff repair (ARCR) is a technically demanding procedure. The purpose of this study was to quantify the learning curve by analyzing the operative time. 180 cases of ARCR(mean age 59 years old, range 21 to 79 years old, 127 males, 53 females) were performed between March 2003 and February 2006 by a single surgeon. A subacromial decompression was added to all cases except those with massive tears. Suture anchors were used to repair the cuffs. If the cuff was mobile enough, the double row method was applied (49/180 cases, 27%). There were 20 partial thickness(11%), 47 small(26%), 69 medium(38%), 25 large(14%), and 19 massive tears(11%). The learning curve was analyzed with the operative time. Also, the correlation of the operative time with the number of suture anchors used and the size of the tear were evaluated. Consecutive blocks of 20 cases were analyzed. The mean operative time and the standard deviation for the first block was 153+25 minutes (122-194 min.), and 72+21 minutes (42-112 min.) for the last block. At the third block (case number 61-80), the mean operative time became less than 2 hours. The operative time decreased rapidly during the first 100 cases. The mean number of the suture anchors used was 2.0, and it was correlated with the operative time (Spearmans rho = 0.43, p<0.0001). The size of the tear was also correlated with the operative time (Spearmans rho = 0.39, p<0.0001). The operative time rapidly decreased during the first 100 cases. The size of the tear and the number of suture anchors were correlated with the operative time.