広範囲腱板断裂に対する短期術後成績

概要

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Background: We reported results of a dual-row fixation and a suture bridge fixation for arthroscopic rotator cuff repair(ARCR) of massive rotator cuff tear and infraspinatus muscle transfer for irreparable massive rotator cuff tear. Methods: We performed dual-row fixation in 4 shoulders, suture bridge fixation in 5 shoulders and infraspinatus muscle transfer in 25 shoulders. The average age at operation was 63, 63 and 70 years old, the mean interval from the time of the operation to the final follow-up evaluation was 24, 20 and 22 months respectively. Results: The average postoperative JOA score was 87.3 in dual-row fixation, 76.9 in suture bridge fixation and 87.9 in infraspinatus muscle transfer. Postoperative JOA score improved significantly compared with the pre-operation JOA score in all groups. Postoperative MRI according to Sugaya was 1 type III, 3 type IV in dual-row fixation and, 2 type III, 3 type IV, in suture bridge fixation. Infraspinatus muscle transfer showed no infraspinatus tendon tear after surgery in postoperative MRI. Conclusion: Infraspinatus muscle transfer was an effective method for not only irreparable massive rotator cuff tear, but also massive rotator cuff tear with preoperative muscle degeneration.