腱板断裂に対する重層固定式 mini-open 法の治療成績

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The purpose of this retrospective study was to assess the clinical outcomes of arthroscopy-assisted mini-open double-row repair (MODR) for small, medium, and large-sized rotator cuff (RC) tears. Between 2007 and 2009The, RC repairs waswere performed on 63 patients from 2007 to 2009. We reviewed the clinical results of MODR for full-thickness tears in 28 patients (right 20, left 8). These patients were divided into 3 groups according to the Cofields classification; Group S (<1cm) involved 3 shoulders, Group M (1-3cm) in 18 shoulders, Group L (3-5cm) in 7 shoulders. The mean age at surgery was 50 years old (range, 35-73), and the mean follow-up period was 31.4 months (range, 16-42). We performed MODR method using suture anchor (avg. 2.3 anchors) after arthroscopic subacromial decompression. We clinically assessed the postoperative re-tear rate of RC tendon (using MRI), isometric abduction power, JOA score, and Constant score at final follow-up. The data were analyzed using Chi-square and paired t tests. The postoperative re-tear rate was 10.7% overall (3/28 cases) and 0%, 5.6%, and 28.6% in groups S, M, and L, respectively (p=0.93). The isometric abduction power significantly differed preoperatively (mean 3.9kg; range, 0-9) and postoperatively (mean 6.2kg; range 2.3-11.3) (p<0.05). The average JOA and Constant scores were 62.5 (range, 42-86.5) and 49 (range, 29-78) points, preoperatively, and 94.5 (range, 82.5-100) and 83.4 (range, 71-95) points, respectively, at final follow-up (p<0.05). No statistical difference was found in the postoperative re-tear rate of RC tendon between the 3 groups. The MODR method for full-thickness RC tears can provide significant clinical and functional improvement.

腱板断裂に対する重層固定式 mini-open 法の治療成績

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