肩関節広範囲腱板断裂の術後成績に影響する因子について

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[Purpose] The purpose of this study was to investigate the factors in preoperative radiographs and MRI which would influence the results of surgery for the massive rotator cuff tear.[Materials and methods] Radiographic and MRI studies were performed in 33 shoulders of 31 patients who underwent surgery for a massive rotator cuff tear using McLaughlins procedure modified by Nobuhara. This procedure is indicated for massive rotator cuff tears which cannot be repaired using the conventional McLaughlins procedure. The age of the patients ranged from 44 to 78 (average 66.9) years. They were divided into four groups according to Gerbers classification and into three groups according to Thomazeaus classification. The JOA score of the patients was also evaluated at the final follow-up and the relationship between the final JOA score and severity of arthritis and that between the score and the supraspinatus atrophy was assessed.[Results] The average JOA score was 92.6 points at the final follow-up in the 33 shoulders. There was no significant difference in the final JOA score between the patients with mild arthritis and those with moderate arthritis. However, the patients with a thicker supraspinatus muscle demonstrated significantly higher JOA scores than those with a thinner muscle (p<0.01). The clinical results of the Nobuharas procedure for the massive rotator cuff tear was good or excellent in almost all the patients except for several patients with insufficient recovery of muscle power.[Conclusion] The low postoperative JOA score was related with preoperative supraspinatus muscle atrophy but not with preoperative osteoarthritis of the shoulder.
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肩関節広範囲腱板断裂の術後成績に影響する因子について

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