腱板広範囲断裂に対する鏡視下大腿筋膜移植術 −直視下法との比較−

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We have performed open fascial patch grafting (O method) and arthroscopic fascial patch grafting (A method) for massive rotator cuff tears. The purpose of this study is to evaluate the clinical results of 2 different operative methods. We treated 67 patients with fascial patch grafting for massive rotator cuff tears. A method group was 17 cases (11males, 6 females; mean age 67.8years old). O method group was 27 cases (18 males, 9 females; mean age 62.1years old). Sex, the averaged age at operation, the mean follow up period was not significant in either group. Clinical results were evaluated according to the Japanese Orthopaedic Association score (JOA score). Cuff integrity was evaluated by MRI. The average postoperative JOA score improved from 55.3 to 83.3 in A method, and from 59.4 to 85.3 in O method. There was no significant correlation between postoperative JOA and the 2 different operative methods. Poor result were obtained in 4cases in A method, and 5 cases in O method causing limitation of range of motion and loss of muscle strength. Retear of rotator cuff observed by MRI were 4cases in A method, and 5 cases in O method.The clinical results of arthroscopic and open fascial patch grafting for massive rotator cuff tears were mostly satisfactory.