抄録
Among 85 patients with 87 cuff tears older than 50 years old treated by the open repair using McLaughlin's methods, 11 shoulders had a preoperative disability of the shoulder elevation with an active elevation less than 90 degrees after a xylocaine test and a passive elevation more than 90 degrees. Clinical findings and postoperative results of these 11 shoulders were investigated. Patients' mean age at the operation was 65 years old and the mean follow-up period was 15 months. The preoperative active elevation averaged 44 degrees and 5 shoulders had a superior migration of the humeral head less than 5mm of the acromiohumeral interval (AHI). Mechanisms of onset, the location and the size of cuff tears, degenerations of a bicipital long head, JOA score, the postoperative active elevation and retear rate were investigated. The relationship among postoperative JOA scores with age, the presence of the superior migration and tear size were evaluated. The mechanism of onset was trauma in 5, continued degenerative tears in 3 and trauma added to pre-existed degenerative tears in 3 shoulders. All 11 rotator cuff tears were involved at more than 2 tendons containing both supraspinatus and infraspinatus. The size of tears was 30 ∼ 50mm in 6 and more than 50mm in 5 shoulders. Bicipital long heads showed ruptures in 2 and dislocations in 2. The mean total JOA scores increased from 46.7 preoperatively to 83.5 postoperatively(p<0.01). Active elevation more than 90 degrees was obtained in 9 shoulders(82%) and the retear rate was 36%. Good results were obtained by the open repairs with McLaughlin's methods, but the JOA scores were significantly lower in cases with an age of over 65 years old, tear size over 50mm and a superior migration less than 5mm of AHI.
