肩甲下筋腱修復が必要であった肩腱板断裂手術の臨床経過

概要

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Background: The purpose of this study was to investigate the clinical course after arthroscopic rotator cuff repair (ARCR) involving subscapularis tendon (SSC) tear. Methods: From January 2008 to May 2010, 23 cases suffering from SSC tear were operated on with arthroscopic suture anchor technique and 17 cases followed for at least 1 year were enrolled in this study. The average age at operation was 62.7 years old. A solitary SSC tear was observed in 2 cases, and SSC tears and concomitant supraspinatus tendon tears with or without infraspinatus tendon tears were observed in 15 cases. JOA scores were calculated at 6 months and 12 months postoperatively. The repair integrity was evaluated using MRI findings. The SCC tears were evaluated arthroscopically and were classified according to that evaluation by Nagasawa's classification and Ide's classification Results: The average JOA scores improved from 60.5 points to 87.3 points at 6 months postoperatively and sill improved significantly from 87.3 points at 6 months to 90.6 points at 12 months postoperatively. This improvement from 6 months to 12 months didn't depend on ROM scores but pain scores. The postoperative MRI showed the SSC re-tear in only 1 case. Conclusion: This study suggested that ARCR with SSC repair for the treatment of patients with SSC tear yielded successful clinical and structural outcomes but 6 months were not enough of a period for recovery, especially pain.