ポリグルコール酸 (PGA) シートによる一次修復不能な腱板断裂の治療

概要

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We reported that poly-glycolic acid sheet (PGA) was effective experimentally for the regeneration of the insertion and the proper portion of the rotator cuff tendon. We clinically used the PGA sheet for the repair of the massive rotator cuff injuries. From 2001, we performed rotator cuff repair on 336 cases. Out of 336 cases, patch graft was performed on 62 cases. Thirty two cases had patch graft using the tensor fascia lata performed (PG group) and 30 cases had patch graft using the PGA sheet performed (PGA group). 41 cases were male, 21cases were female. The average age was 58.5 years old. We evaluated the clinical results using JOA score. The MRI findings were evaluated by using Spielmann criteria. The clinical results were analyzed statistically. The average JOA score improved from 54.9 points to 91.7 points postoperatively in the PG group and from 52.6 points to 90.7 points postoperatively in the PGA group. Many cases of the PGA group showed a slightly high intensity area in the repaired rotator cuff on MRI findings. In blood examination, the values of CRP were almost normalized with time by 3 weeks after surgery. There were no remarkable complications such as hydroarthrosis and destruction of bone tissues. We applied the PGA sheet for the purpose of repair of massive rotator cuff tear. The clinical results were preferable.