関節包側腱板不全断裂残存腱の病理学的検討
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<B>Background:</B> The approach for repair of a PASTA (partial articular surface tendon avulsion) lesion includes either completing the tear of the remaining tendon followed by a standard rotator cuff repair, or a transtendon repair that preserves the residual tendon. The object of this study was to describe the histopathological features of the residual tendon tissue in PASTA lesion. Our hypothesis was that macroscopically intact residual tendon in a PASTA lesion would show histopathological degeneration.<BR><B>Methods:</B> In 35 consecutive patients with PASTA lesion biopsies of the residual tendon were taken. The mean age was 60.3 years old (range 28-78). All tears were converted to full thickness tears and arthroscopically repaired. The samples were histopathologi-cally examined and graded using a modified semi-quantitive scale (between 0 as normal appearance and 21 as most abnormal appearance). Data were analyzed using multiple regression analysis to estimate the effect of aging, smoking status, duration of pain, and steroid injections.<BR><B>Results:</B> Degenerative changes were evident in 33 of the 35 cases (94%). The mean modified semi-quantitative grading scale was 10.5 (range 3-16, SD, 2.7). Multiple regression analysis failed to show a statistically significant correlation between the score of the modified semi-quantitative grading scale and aging, smoking status, duration of pain, or steroid injections.<BR><B>Conclusion:</B> Most of the macroscopically intact residual tendon tissues of the PASTA lesions showed moderate histopathologic degeneration. Our results suggest that transtendon technique may leave residual degenerative tendons, which may diminish the outcome.
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