次修復不能な腱板広範囲断裂に対する鏡視下腱板部分修復術の MRI 評価

概要

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Background: We performed arthroscopic partial rotator cuff repair (APRCR) for irreparable rotator cuff tear. The purpose of this study was to evaluate the MRI images after APRCR. Methods: We retrospectively studied 18 patients (19 shoulders) who had received APRCR with arthroscopic subacromial decompression (ASD) and who were followed up for more than 1 year. The patients were 11 males and 8 females. The mean age at the time of operation was 68 years old (range, 51-86). The mean postoperative follow-up period was 20 months (range, 12-33). The clinical results were assessed using JOA scores. MRI findings were assessed by Sugaya's classification, acromio-humeral distance and distance from coracoid process to humeral head. Results: The mean JOA total score was significantly improved from 58 points preoperatively to 90 points postoperatively. Postoperative MRIs showed 26% re-torn for ISP tendon, and 33% re-torn for SSC tendon. Acromio-humeral distance was not changed postoperatively, but the distance from the coracoid process to the humeral head was increased from 6.4mm preoperatively to 6.5mm postoperatively, but it was not significant. Conclusion: In this study, the clinical results of APRCR were mostly satisfactory. Wiley et al. reported that ASD for massive rotator cuff tear could progress antero-superior migration of humeral head. However, in this study, we did not have antero-superior migration cases after APRCR.