鏡視下腱板修復術症例の世代別の特徴

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Age is one of the most important factors when we make a decision for the indication of surgery. The purpose of this research is to investigate the clinical features related to generations in arthroscopic rotator cuff repair (ARCR). From August 2005 to July 2008, we performed ARCR in 107 shoulders (71 male,s 36 females). They consisted of 8 shoulders in patients in their twenties and thirties, 11 shoulders in patients in their forties, 28 shoulders in patients in their fifties, 40 shoulders in patients in their sixties and 20 shoulders in patients in their seventies. Among generations in these cases, we compared preoperative factors, intra-operative findings, postoperative rehabilitation, and postoperative clinical results, retrospectively.As to preoperative factors, patients in their seventies have the lower scoring system of the Japanese Orthopaedic Association (JOA), especially in functional subscore. As to intra-operative findings, there was a significantly high rate of contracture, lower cuff mobility, and delamination in the tear cuff in patients in their seventies. There was no difference as to postoperative rehabilitation. But the patients in their forties tend to have slower recovery of range of motion, so they should have rehabilitation for a longer period.In the postoperative clinical results, patients in their seventies have significantly lower JOA score (86.5 points) at 12 months postoperatively and a significantly higher re-tear rate (40%) at 6 months, compared to other generations. Our research suggests that the patients younger than 70 years old have an appropriate indication for ARCR generally. On the other hand, it needs considerable decision making for ARCR in the patients older than 70 years old, because they are expected to have lower postoperative clinical results.

鏡視下腱板修復術症例の世代別の特徴

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