上腕二頭筋長頭筋腱欠損が広範囲腱板断裂例の肩関節機能低下および回復に及ぼす影響

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Background: Long head of the biceps brachii (LHB) tendon has an important role in maintaining shoulder function. LHB tendon ruptures sometimes occur in the cases of rotator cuff tears. Severe shoulder dysfunction was recognized in massive rotator cuff tears, though the influence of LHB tendon deficiencies in such cases is not well known. The aim of this study was to determine the influence of LHB tendon deficiencies on shoulder dysfunction or recovery in shoulders with massive rotator cuff tears. Methods: We evaluated 85 shoulders that had undergone arthroscopic rotator cuff repair surgeries for massive rotator cuff tears. We evaluated LHB tendon during arthroscopy; 26 shoulders were classified into the group of LHB deficiencies (group minus) and 59 shoulders were classified into the group of intact LHB(group plus). We assessed each surgical procedure as a complete repair or an partial repair. Clinical outcomes were evaluated by the JOA shoulder scoring system, active ROM preoperatively and postoperatively. Each parameter was statistically analyzed between the two groups. Results: The average preoperative JOA scores and active ROM were not different between two groups. Complete repair was performed in 15/26(58%) cases in group minus and in 50/56(89%) cases in group plus. Postoperative clinical results were significantly lower in group minus than those in group plus when partial repair was included. Conclusion: LHB tendon deficiencies do not have an influence on preoperative shoulder dysfunction in shoulders with massive rotator cuff tears. However, LHB tendon deficiencies make complete rotator cuff repair more difficult than intact LHB tendon does. Postoperative clinical results were not different between two groups when excluded partial repair.

上腕二頭筋長頭筋腱欠損が広範囲腱板断裂例の肩関節機能低下および回復に及ぼす影響

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