Ｄｅｌａｍｉｎａｔｉｏｎを伴う肩腱板大断裂に対する鏡視下Ｔｒｉｐｌｅ‐Ｒｏｗ固定法の短期治療成績

概要

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This study investigated the early clinical outcomes and cuff integrity of triple row fixation after arthroscopic repair of large rotator cuff tears with delamination. We evaluated 12 shoulders in 12 patients (10 males and 2 females, average age: 59.1 years old). The average follow-up period was 19.5 months (range: 13-26 months). The triple-row surgical technique was performed using a third row of fixation placed between the typical medial and lateral rows. One year postoperatively, the clinical outcomes and cuff integrity were assessed by JOA score and Sugaya's MRI classification, respectively. Muscle strength was measured with MicroFET preoperatively and one year after surgery. The average JOA score improved from 58.5 to 93.5 points. On MRI study, type 1 repair was seen in 7 shoulders, Type 2 repair in 4 shoulders, and Type 5 in 1 shoulder. The re-tear rate was 8.3 percent. The average JOA score in the re-tear group was 76.5 points. The average shoulder abduction strength improved from 34.3 to 86.1 N at 45°of abduction (P<0.0001), and from 31.8 to 81.5 N at 90° of abduction (P<0.0001). External rotation strength improved from 29.1 to 78.8N (P<0.0001). Internal rotation improved from 60.5 to 88.1 N (P<0.0001). The arthroscopic triple row suture anchor method for large rotator cuff tears with delamination yielded excellent outcomes. This procedure is an effective option for selected patients demonstrating large rotator cuff tears with delamination.