肩甲下筋腱完全断裂に対する重層固定法を用いた鏡視下手術成績

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[Purpose] The purpose of this study was to evaluate structural integrity and clinical outcomes after arthroscopic double-row repair for full-thickness subscapularis tendon tears. [Material and Method] From Mar. 2005 through Sept. 2008, 32 patients underwent arthroscopic double-row repair. The patients, 22 males and 10 females, with an average age of 62.5 (40-75) years old at the time of their surgeries were included. The mean postoperative follow-up period was 20.2 (12-54) months. Surgery was performed in beach chair position. The anterosuperior portal was mainly utilized for a viewing portal. Anatomical footprint reconstruction was performed using two or three anchors. The anchors were placed in a triangular position, making the superior side broader, to reconstruct the anatomical insertion. And the cord-like structure (comma), which connects to the superolateral border of subscapularis tendon, was preserved and used to achieve a strong and anatomical repair. The clinical evaluation was performed using the JOA shoulder score, UCLA score. The repair integrity using MRI T2-weighted imaging was evaluated at 1 year after surgery. [Result] JOA shoulder score was improved from 77.8 to 91.4, UCLA score was also improved from 20.6 to 34.2. According to the Sugayas classification Postoperative MRIs revealed 15 type1, 9 type2, 5 type3, 0 type4 and 3 type5. [Conclusion] Arthroscopic double-row repair by using comma for full-thickness subscapularis tendon tear yielded successful functional outcomes and resulted in structural outcomes.

肩甲下筋腱完全断裂に対する重層固定法を用いた鏡視下手術成績

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