修復不能な広範囲腱板断裂に対する鏡視下デブリドマンの治療成績

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The purpose of this study was to evaluate the clinical results of arthroscopic debridement (AD) for irreparable rotator cuff tears (IRCT). AD was performed on 31 patients (32 shoulders) with IRCT from 1995 to 2009. There were 18 males and 13 females with a mean age of 69.6 years old. The mean follow-up period was 18.4 months. The indication of AD in our hospital was the low-demand patient, the patient for whom it was not necessary to resume heavy physical work, and the patient whose cuff stump on the glenoid was recognized or the rotator cuff over the footprint of the greater tuberosity was not recognized on MRI. The arthroscopic synovectomy of the gleno-humeral joint and subacromial bursa were performed, whereas arthroscopic subacromial decompression was not performed usually. A pendulum exercise was initiated from 3 days after the surgery and an active-assist exercise was started from 7 days after the surgery. The pre and post-operative Japanese Orthopaedic Association score (JOA score), the elevation and the external rotation were evaluated. The effect of the age or the degree of osteroarthritis (OA) for clinical results was also evaluated. The mean JOA score, the pain score, the elevation and the external rotation were 55.4 points, 10 points, 94.2° and 32.7° preoperatively and 82.1 points, 22.8 points, 128.1° and 40.5° postoperatively, respectively. Significant differences were founded in the JOA score, pain score, and elevation, although no significant difference was founded in the external rotation. The age did not influence in the clinical results, whereas the degree of the osteoarthritis significantly did. The clinical results of AD for IRCT were generally good.

修復不能な広範囲腱板断裂に対する鏡視下デブリドマンの治療成績

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