広範囲腱板断裂に対する大腿筋膜を用いた鏡視下パッチ法の術後成績
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概要
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<B>Hypothesis:</B> To reduce the retear rate, patching using the femoral fascia is performed under arthroscopy for massive rotator cuff tear. We reviewed the postoperative clinical outcomes and MRI findings in patients 1 year after surgery. In addition, the findings were compared with those after arthroscopic primary repair.<BR><B>Methods:</B> The subjects were 28 patients aged 58-85 years old. The subscapularis tendon and infraspinatus tendon were partially repaired and the femoral fascia, folded in half, was grafted to the defect. Thirteen patients using primary repair were evaluated as references. The range of motion (ROM), abduction muscle strength (MMT), and Japan Orthopedic Association score (JOA score) before and 1 year after surgery were evaluated. MRI was performed 1 year after surgery, and the images were evaluated using Sugaya's classification.<BR><B>Results:</B> ROM, JOA score and MMT improved significantly after surgery. Sugaya's classification was G1 in 8, G2 in 7, G3 in 4, G4 in 6, and G5 in 3, and the retear rate, calculated by defining G4 and G5 as retear, was 32%. There were no significant differences between patch group and primary repair group comparing the JOA and ROM. MMT score showed significant improvements in the patch group compared with the primary repair group. Retear rate was 32% in patch procedure and 79% in primary repair.<BR><B>Conclusion:</B> MMT score was improved after surgery, and the retear rate could also be reduced to 32% using patch procedure. Therefore, the patch procedure is considered to be an effective treatment for massive rotator cuff tear.
- 日本肩関節学会の論文
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