腱板断裂の長期成績 −術式による比較について−

概要

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We investigated the long term clinical results of the rotator cuff repair. Out of 840 cases, we followed up 26 cases of large or massive rotator cuff tear. The average follow up period was more than 10 years. 16 cases were male, 10 cases were female. The average age was 62.5 years old. The side by side suture (SS) was performed for 7cases, the McLaughlin procedure (ML) for 9cases, the patch graft (PG) for 5 cases, and the suture anchor procedure (SA) for 5cases. We evaluated the clinical results using JOA score. The X-ray findings were evaluated from the point of osteoarthritis change. We analyzed the data statistically by Mann-Whitney U test. The average JOA score improved from 56.2 points to 81.5 points postoperatively in the SS group, from 53.3 points to 85.6 points in the ML group, from 54.6points to 86.1 points in the PG group and from 51.5 points to 83.3 points in the SA group. The pain has improved in all groups. The ROM did not improve well. Especially, the abduction and external rotation did not recover well. Also the MMT of the external rotation did not recover well. This limitation and the power loss of the external rotation influenced the ADL, especially for eating. The average AHI was less than 7mm in all groups. Osteoarthritis changes were found in 3 cases. The long term clinical results of open surgery and arthroscopic surgery were preferable.