肩腱板広範囲断裂術後長期における画像と臨床評価の検討

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Background: The purpose of this study was to examine images and clinical evaluation global rotator cuff tears in the long-term postoperatively. Methods: 10 shoulders (9 males and 1 female) examined this year were evaluated.The average follow-up period was 14.8 years (range: 12-21), and mean age at the time of examination was 72.5 years old (range: 62-92). Superior migration of the humeral head and osteoarthritis changes were examined with X-P. Cuff integrity and fatty infiltration were examined with MRI. Clinical results were evaluated with JOA score and UCLA score. Results: AHI(acromio-humeral interval) was an average of 3.7mm (range:0-9.2) and decreased in all cases. Superior migration was observed but osteoarthritis changes had not progressed. In cuff integrity, 7 cases (70%) were Sugaya's Classification types 4+5. Similarly, in fatty infiltration, 7 cases (70%) were Gutallier's Classification grade3+4. 8 shoulders acquired complete Zero Position. Active flexion, abduction, and external rotation angle were an average of 129 degrees (range: 85-150), 104 degrees (range: 70-140), and 19.5 degrees (range -40-60) respectively. The average JOA score was 81(range: 60-87).There were no correlations between postoperative AHI and other values. Preoperative indicators of upward migration of the humeral head, and indicators of cuff integrity were correlated with JOA score. Conclusion: In the long-term post repair of global rotator cuff tears, superior migrations of the humeral head tended to progress but were not necessarily correlated with clinical outcome. But, less superior migration preoperatively, and better cuff integrity did contribute to a better clinical outcome.

肩腱板広範囲断裂術後長期における画像と臨床評価の検討

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