腱板広範囲断裂の臨床成績と MRI 評価

概要

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Background: We expect that postoperative oblique-sagittal MRI is useful for the evaluation of clinical results of operations for massive tear of rotator cuff (MT). Methods: We examined 31 cases of repaired MT. We defined MT as the stump of cuffs laid on or beyond labrum on the oblique-coronal image of MRI and the torn area widened from anterior facet to middle or inferior facet on the oblique-sagittal image. Operations were done with Arthroscopic rotator cuff repair or open repair. The oblique-coronal image was evaluated by Sugaya's classification. The width of high signal area of the rotator cuff was measured in the oblique-sagittal image (M value). The clinical results were evaluated with JOA score without stability and X-ray evaluations. Results: The mean JOA score was significantly improved from 45.2 points preoperatively to 63.7 points postoperatively. Postoperative MRIs were classified as, one shoulder of Type I, 11 of Type II, 5 of Type III, 2 of Type IVand 12 of Type V by Sugaya's classification. Postoperative M value had a range from 0 to 46 mm. In Type IV V, 5 shoulders had less than 23 mm postoperative M value and 74.7 points of mean postoperative JOA score. The other 9 shoulders had 48.0 points. Conclusion: In re-tear cases of MT, the clinical results were good in cases with continuity of rotator cuff between the top of humeral head and glenoid on the oblique-sagittal MRI.