腱板断裂に対する重層固定法を用いた鏡視下腱板修復術の臨床成績

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The purpose of this study was to evaluate the clinical results after arthroscopic rotator cuff repair using the dual-row technique (ARCR-DF) for full-thickness rotator cuff tears. We evaluated 11 patients (10 males and 1 female) repaired by the dual-row technique, from November 2004 and were consequently followed-up for more than 1 year postoperatively. The affected shoulder was on the right side in 10 patients and on the left side in 1 patient. The average age at operation was 60.3 years old (36 to 75 years old); the mean pre-operation period was 11.3 months (0.5 to 48 months); and the mean follow-up period was 15.3 months (12 to 23 months). The tear type was small in 1, medium in 6, and large in 4. We arthroscopically performed subacromial decompression and sutured the torn cuff to the greater tuberosity using suture anchors according to the dual-row technique. We put the arm on a shoulder abduction brace for 4 weeks. For a clinical follow-up, we used the Japanese Orthopaedic Association score (JOA score). According to the JOA score, the average total score increased from 69.6 points to 96.8 points. The average scores of pain, function, and motion improved from 10.9 to 28.2 points, from 16.2 to 20 points, and from 23.2 to 28.8 points, respectively. We evaluated the shoulder muscle strength. The average abduction strength increased from 3.38±2.48kg to 6.1±2.26kg. The average external rotation strengths at the side and at the 90 degree abduction increased from 4.33±2.68kg to 8.11±2.22kg, and 4.58±3.13kg to 9.18±2.53kg, respectively. We also evaluated the postoperative MRIs. Postoperative MRIs showed 18.2% of re-torn cuff. The clinical outcome of the ARCR-DF was almost satisfactory, but patients with large tears tend to retear.
日本肩関節学会の論文

腱板断裂に対する重層固定法を用いた鏡視下腱板修復術の臨床成績

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