鏡視下腱板修復術後再断裂症例の検討

概要

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This study was conducted to evaluate clinical and structural characteristics of retorn cuffs after arthroscopic rotator cuff repair (ARCR). 90 complete torn cuffs were treated with arthroscopy. 47 males and 38 females were included. The mean follow-up period was 18 months. The magnetic resonance images (MRI) were taken 6 and 12 months after an operation. The subjects were divided into two groups according to Sugayas MRI classification: group A (good cuff integrity) and group B (retear). Preoperative and postoperative factors (age, JOA score, intraoperative tension of torn cuff, MRI, etc.) were compared between the two groups. Ten cuffs (11.1%) were re-torn. Postoperative JOA score in group A was 92.9 points, which was significantly higher than in group B (86.8 points). The intraoperative tension of torn cuffs in group A and B were 1.9kg and 3.1kg, respectively. Five shoulders in group B observed stage 3 muscle atrophy according to Goutalliers classification. In almost all cases, muscle atrophy was constant or progressive according to postoperative MRI. ARCR for shoulders with large tear size and more than stage 3 muscle atrophy were considered to be able to improve clinical symptoms, but to be difficult to keep repair integrity.