腱板断裂一次修復不能例に対する腱板再建術（パッチ移植術と広背筋移行術）の成績

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It was reported that the postoperative outcome for irreparable rotator cuff tears was inferior to that for reparable tears. The purpose of this study was to clarify the outcome of the patch graft procedure (patch) and the lattissimus dorsi (LD) transfer for the irreparable rotator cuff tears. There were 21 patients, 23 shoulders (male: 20, female: 23) who underwent patch with the long head of biceps or tensor fascia lata or LD for irreparable rotator cuff tears from 1995 to 2008. Patch was done in 16 patients, 17 shoulders and LD was done in 5 patients, 6 shoulders . Pre- and Post-operative JOA scores and shoulder muscle strength, which was tested with Microfet were evaluated. The average age at operation was 64 years (49-87), mean follow- up was 44 months (12-141). JOA score significantly increased from preoperative average of 62.6 (46.5-73.5) points. to postoperative average of 89.1 (76.5-100) points. In LD, preoperative and postoperative, respectively, JOA score was 64.4, 89.2, muscle strength of abductor at 90° abd. was 15.3N, 42.6N, that of abductor at 45° abd. was 34.7N, 79.1N, that of external rotator arm at side was 27.3N, 44.6N, and that of internal rotator was 111.9N, 113.8N. In patch, JOA score was 62.0, 89.0, muscle strength of abductor at 90° abd. was 36.8N, 72.4, that of abductor at 45° abd. was 42.6N, 93.7N, that of external rotator arm at side was 25.5N, 54.9N, and that of internal rotator was 106.6N, 147.6N. Patch and LD might be one of the good options for irreparable rotator cuff tears. However, recovery of shoulder muscle strength after surgery might not be expected so much.

腱板断裂一次修復不能例に対する腱板再建術（パッチ移植術と広背筋移行術）の成績

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