鏡視下腱板修復術後の再断裂に関与する因子の検討

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The purpose of this study was to investigate the factors related to re-tears after arthroscopic rotator cuff repair (ARCR). We studied 60 patients who underwent ARCR with a minimum of 1 year of follow-up after the operation. Average age at the surgery was 63.4 years old (41 ∼ 81). Average postoperative follow-up was 19.7 months (12 ∼ 42). Based on the repaired cuff integrity on postoperative MRI findings, the patients were assigned to 2 groups: the repaired group (type I-III in Sugayas classification for repaired cuff integrity) and the re-tear group (type IV-V). Preoperative clinical features (age, active range of shoulder motion, and tear size observed at the operation) and the muscle fatty degeneration were compared between the 2 groups. The muscle fatty degeneration was evaluated by Goutalliers classification on the preoperative MRI. The postoperative MRI showed that the re-tear rate was 20%. The mean age of the re-tear group was significantly higher than that of the repaired group, whereas no statistically significant difference was observed between the active range of shoulder motion and the re-tear rate. The shoulders with large and massive tears had a significantly higher retear rate than the shoulders with small and medium tear (P<0.01). In addition, comparison revealed a statistically significant difference between the preoperative muscle fatty degeneration and the re-tear rate. In conclusion, aged patients, the large tear size, and the increased muscle fatty degeneration contributed to the high re-tear rate after ARCR.

鏡視下腱板修復術後の再断裂に関与する因子の検討

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