鏡視下腱板修復術における修復腱板のTraction-MRI評価

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The purpose of this study was to reveal the functional outcome of arthroscopic rotator cuff repair and to evaluate the postoperative cuff integrity by traction-MRI. 47 shoulders (39 males, 8 females, mean 57 years) were included. All 47 tears (35 complete type (10 small, 21 medium, 4 large), 12 incomplete type (9 bursal-side, 3 articular-side) were repaired using the single-row technique. The mean follow-up period was 31 months (range 17-48) and the clinical outcome was assessed using the JOA score. Postoperative cuff-integrity was evaluated by traction-MRI, performed at both 4 and 12 months postoperatively. MR findings of T2WI were classified into 3 categories (low, intermediate and high). On MRs, low signals were observed in only 21% at 4 months but increased significantly to 53% at 12 months. Intermediate signals were seen in tendons in 63% of the shoulders at 4 months and in 37% at 12 months. High signals were seen in tendons in 16% of the shoulders at 4 months. This rate decreased to 11% at 12 months. In the shoulder joint, high signals were seen in 56% at 4 months, the rate which decreased to 26% at 12 months. In the bursa, high signals were seen in 74% at 4 months and 63% at 12 months. The average total JOA score improved from 66.2 (pain: 9.1, function: 14.8, ROM: 23.6) to 93.5 (pain: 27.2, function: 19.5, ROM: 26.7) in all the cases, from 65.5 to 95.9 in the low group, from 66.6 to 94.9 in the intermediate group and from 68.4 to 76.8 in the high group. The functional outcome of this procedure was quite satisfactory. MR findings revealed serial signal changes after surgery, which suggested the morphologic improvement at the tendon-bone junction. This study suggested that better functional outcome may be established in shoulders with better postoperative cuff integrity.
日本肩関節学会の論文

鏡視下腱板修復術における修復腱板のTraction-MRI評価

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