肩甲下筋腱断裂に対する鏡視下手術例の検討

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Background: Subscapularis tendon tears are rare injuries. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of subscapularis tendon. Methods: Eight shoulders in 8 patients (4 males, 4 females, 6 right and 2 left shoulders) who underwent arthroscopic repair of subscapularis tendon between April 2005 and March 2011 were reviewed. The average age at the time of operation was 66.1 years old (32-84 years old). Seven tears were traumatic and one was degenerative. Lift-off and belly-press tests were positive in all patients. Full thickness tear of subscapularis tendon was observed by MRI. Isolated tears of the subscapularis tendon were observed in 2 cases, 3 cases combined with a supraspinatus tendon tear, and 3 cases combined with a supraspinatus and an infraspinatus tendon tear. The subscapularis tendon was refixed arthroscopically to the lesser tubercle using an anchor. The average interval from the onset of symptoms to the time of surgery was 6.3 months (3-13 months). The average duration of follow-up was 16.1 months (6-72 months). Clinical outcomes were evaluated with JOA score and MRI classified according to Sugaya's classification. Results: Postoperative MRI revealed 3 type I, 2 type II, 2 type III, and 1 type V. The average JOA score was improved from 66.1 points (45-83 points) to 82.8 points (69-91 points). Discussion: JOA score improved for pain after the operation. Improvement of the internal rotation strength indicates that subscapularis tendon function was reformed. Conclusion: The subscapularis tendon tears treated by arthroscopic repair were improved significantly.

肩甲下筋腱断裂に対する鏡視下手術例の検討

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