腱板大断裂 • 広範囲断裂に対する鏡視下腱板修復術後の成績不良例の検討
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<B>Background:</B> We analyzed the clinical results after arthroscopic rotator cuff repair (ARCR) in patients with large and massive rotator cuff tears to evaluate the unsatisfactory outcomes after surgery.<BR><B>Methods:</B> We selected 25 patients who had undergone ARCR by the dual-row technique for the treatment of large and massive rotator cuff tears. All patients were followed-up for more than 2 years old. The average age at operation was 67.4 years. We determined the JOA score, the Constant score, shoulder active flexion and abduction range of motion, and shoulder abduction and external rotation strength preoperatively, and at postoperative 6 months, 1 year, and 2 years. We evaluated the cuff integrity by using MRI or ultrasonography. A patient having a JOA score of less than 70 points and postoperative rerupture was considered to have an unsatisfactory outcome. We comparatively studied patients who had unsatisfactory outcomes and other patients with regard to age, gender, occupation or sports activity, preoperative period, existence of trauma, dominant side, the preoperative JOA score, the Constant score, shoulder active flexion and abduction range of motion, shoulder abduction and external rotation strength, and existence of rerupture.<BR><B>Results:</B> There were 4 patients with unsatisfactory outcomes at postoperative 2 years. The preoperative Constant score of both sides and preoperative active abduction range of motion were statistically lower in the patients with unsatisfactory outcomes.<BR><B>Conclusion:</B> Risk factors of unsatisfactory outcomes after ARCR for large and massive rotator cuff tears were the preoperative Constant score of both sides and preoperative active abduction range of motion.
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