腱板断裂に対する鏡視下腱板修復術の治療経験

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Excellent results of arthroscopic rotator cuff repair have been reported recently. However, a skillful arthroscopic technique may be one of the factors to lead to this excellent outcome. We treated rotator cuff tear arthroscopically 38 shoulders of 37 patients. To clarify the results of our cases, we investigated the outcome of surgery by JOA scores and MRI. The patients included 24 males, 13 females with a mean age of 64 (23-79) years old. The mean follow-up period was 15 months (8-27 months). A complete tear was in 14 shoulders including 3 small, 5 medium, 4 large and 2 massive rotator cuff tears. An incomplete tear was in 24 shoulders including 5 glenohumeral joint side, 19 subacromial bursal side. We performed a double-row method for a rotator cuff tear using suture anchors. A PTFE felt patch was used for massive rotator tears. Arthroscopic subacromial decompression (ASD), debridement and side to side sutures were performed for incomplete tears. The JOA score had improved from an average of 57.5 to an average of 87.2. MRI findings after 15 months were type I, 2 shoulders, type II, 4 shoulders, type III, 4 shoulders, type IV 2 shoulders and type V, 2 shoulders. The Re-rupture rate was 28.6%(4/14) by MRI including 3 cases of large tear. ASD and side to side suture was effective for an incomplete tear. A PTFE patch had excellent clinical results. Therefore, we need to analyze a more effective arthroscopic skill of large rotator cuff tear in the future.

腱板断裂に対する鏡視下腱板修復術の治療経験

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