鏡視下腱板修復術後の機能回復は直視下腱板修復術より優れるか？
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It is controversial as to whether postoperative functional recovery is better with arthroscopic rotator cuff repair (ARCR) than open rotator cuff repair (ORCR). The purpose of this study is to compare postoperative recovery of evaluation score, muscle power and ROM between the 2 procedures. Eleven shoulders after ORCR (7 men and 4 women, average age: 66.8 years old, 3 large tear and 8 medium tear) and 16 shoulders after ARCR (10 men and 6 women, average age: 59.8 years old, 2 large tear and 14 medium tear) were included in this study. Successful repair of the tendon was confirmed by MRI in all cases. JOA score at 6 and 12 months after surgery, muscle strength (flexion, abduction, and external rotation) at 6 months, and postoperative recovery of ROM (flexion, abduction, external rotation, and internal rotation) until 12 months were investigated. Statistical analysis was performed with the use of Mann-Whitney's U test (P<0.05; significant). The average JOA score (6 months / 12 months) was 90.5 / 93.5 points in ORCR and 91.2 /94.6 points in ARCR. There were no significant differences between ORCR and ARCR. Muscle strength at 6 months was better in ARCR. Active flexion and passive internal rotation at 90° abduction position at 12months were significantly better in ARCR. Postoperative JOA score and pain were improved comparably in both groups, however, muscle strength and ROM recovered better in ARCR. Less invasive procedure to the deltoid muscle is considered to be the reason for better functional recovery of ARCR.
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