ポリグリコール酸（PGA）シートによる広範囲腱板断裂の治療成績 －適応と限界－

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Background: We reported that poly-glycolic acid (PGA) sheet was effective for the regeneration of the insertion and the proper portion of the rotator cuff tendon experimentally. We clinically used the PGA sheet for the repair of massive rotator cuff injuries and reported the good results. Methods: The patch graft using PGA sheet was performed on 62 cases. Thirty five cases had the patch graft performed using three layers PGA sheets (3PGA group) and 27 cases had performed using five layers of PGA sheets (5PGA group). 36 cases were male and 26 cases were female. The average age was 61.5 years old. We evaluated the clinical results using JOA score. The MRI findings were evaluated by using Spielmann criteria. The clinical results were analyzed statistically. Results: The average JOA score improved from 54.9 points to 91.7 points postoperatively in the 3PGA group and from 52.6 points to 75.7 points postoperatively in the 5PGA group. Eleven cases of the 5PGA group showed the severe effusion 2 months after surgery. From the MRI findings, 12 cases(45%) had re-ruptured. Discussion and Conclusion: We increased the layers of the PGA sheet for the purpose of the repair of the massive rotator cuff repair. However, severe effusion and reinjury occurred. It is better to use three layers of PGA sheet. Also, we are trying to investigate the effective usage of PGA sheet for new materials.