Teflon Patch を用いた広範囲腱板断裂手術後に著明な関節破壊をきたした 1 例

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The methods for repair of massive rotator cuff tears are tendon transfer procedures, transfers of free autograft tendons, transfers of arograft rotator cuff, and using non-absorbable synthetic materials. We have obtained good clinical results for short times using Teflon patch for reconstructive surgery of irreparable defects of the rotator cuff. But, it was pointed out that resorption of bone at the insertion point of Teflon patch occured in about 30% of patients after 2 to 5 years. We experienced a case of tough disorders and massive resorption of bone after a Teflon patch augmentation for massive rotator cuff tear of the shoulder 14 years ago. We operated on this case with debridment, synovectomy, shoulder arthroplasty and autograft for the glenoid articular fossa suffered from synovitis. In this operation, we found granulation tissues and absorption of bone adjacent to the Teflon patch at the head of humerus and the gleno-humerus joint invaded synovium. The humerus head was sized down, so this rotator cuff was successfully sutured. In conclusion, according to this case, we thought that non-absorbable synthetic materials like a Teflon patch should not be applied simply because of massive rotator cuff. Severe joint disfunction may occur after insertion of synthetic materials.
日本肩関節学会の論文