腱板断裂修復術後の再断裂時期の検討
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<B>Background:</B> It is important to understand when a ‘re-tear’ happens, in order to improve surgical procedures and to provide better post-operative procedures for patients. However, there are few reports about the timing of re-tear after rotator cuff repair(RCR).<BR><B>Methods:</B> From October 2009, the repair condition after RCR was periodically assessed by MRI (at the time of abduction-shoulder-immobilizer removal, 3- and 6-month, and 1-year after operation) to elucidate the timing of re-tear. In this study, we extracted the patients who can be evaluated at least 6 months after operation. 89 shoulders (50 males, 39 females), with an average age of 64.8 years old (35-86) were included in the study. Postoperative cuff integrity was evaluated with MRI and was classified into 5 categories according to Sugaya's classification. Type IV (minor discontinuity) and type V (major discontinuity) were defined as ‘re-tear’.<BR><B>Results:</B> The average timing of abduction-shoulder-immobilizer removal was 3.6 weeks (2-6 weeks). At that time, only 2 shoulders (2.2%) were defined as typeV re-tear and they belonged pre-operatively to massive rotator cuff tear group. The rest of the 87 shoulders (97.8%) maintained the tendon-to-bone integrity. At 3 months, another 9 shoulders (10.1%) were defined as re-tear. At 6 months, an additional one shoulder was classified as type IV re-tear. The overall re-tear rate was 13.5% at 6 months.<BR><B>Conclusion:</B> The period at most risk of re-tear was between 4 weeks to 3 months. It is important to draw patients' attention to this during this period and to provide the appropriate post-operative procedure, in order to decrease re-tear after RCR.
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