広範囲腱板断裂の手術成績の検討～アンカー数との関連について～
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We had 110 cases that we performed arthroscopic rotator cuff repair (ARCR) on and followed up for 6 months. The massive tears occurred in 18 cases. The evaluation of MRI at six months postoperative used Sugaya classification. In the MRI classification, the re-tear group belonging to Type IV, V were 11/110 cases (10.9%). In the massive tears, the re-tear group was 8/18 cases (44.4%). We were unsatisfied with the re-tear rate of the massive tears, so we investigated the relation of some operative factors and the re-tear of massive tears. The examined factors were the number of anchors, the methods of operation, the size of the tear and age. We found no significant differences between the no-tear group belonging to TypeI, II, III and the re-tear group in the size of tear and age, but found significant differences in the number of anchors. The average of the no-tear group was 4.8 and the re-tear group was 3.8. The main methods we used were single row (SR), double row (DR), bridging suture (BS) and margin convergence (MC). In the no-tear group, SR had 0 cases, DR had 8 cases, BS had 2 cases, and MC had 2 cases. In the re-tear group, SR had 2 cases, DR had 3 cases, BS had 3 cases, and MC had 4 cases. In cases that had SR and combined MC and SR re-tear occurred. We showed that the risk of re-tear was increased when we could not insert enough anchors. The desirable number of anchors was more than 5. We have to select the method of patch and graft, if we can not insert enough anchors and can not do DR and BS.
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