当院での肩腱板不全断裂に対する鏡視下腱板修復術の治療成績 および術後の肩峰下侵食像の MRI 評価

概要

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Background: Treatment of partial-thickness rotator cuff tears (PTRCT) is controversial. Recently there have been some reports about knot impingement after arthroscopic rotator cuff repair (ARCR). The purpose of this study was to evaluate the clinical outcome of ARCR for PTRCT and kot impingement. Methods: We evaluated 24 shoulders (21 males , 2 females). Average age at operation was 58.6 years old. The mean follow up period was 10.3 months. There were trauma episodes with 16 cases. Types of PTRCT were bursal-sided tears in 12 cases, intra-tendinous tears in 5 cases and articular-sided tears in 7 cases. PTRCT was over 50% of the tendon and we chose the treatment of completion of PTRCT to full thickness and repair. We investigated JOA score, MRI findings at 6 months postoperatively and complications. We classified subacrominal erosion (SE) into 3 types by MRI. Results: JOA total score increased significantly from 68.9 preoperative to 91.6 postoperative (p<0.05).There were 1 case of postoperative infection and 1 case with CRPS type 1. We investigated 22 cases using MRI. There was 1 case with torn tendon by infection. There were 9 shoulders (40.9 %, 9/22 shoulders) with SE. Conclusion: Clinical outcomes of ARCR for PTRCT were satisfactory. It is neccesary to consider the treatment of ARCR without postoperative SE.