Double Anchor Footprint Fixation 法を用いた鏡視下腱板修復術の MRI 評価：Double Row 法との比較

抄録

Although the conventional double row technique (DR) was a popular surgical technique for rotator cuff tears (RCTs), re-tear rate after an arthroscopic repair with medium to large tears have reported about 20% on MRI study. In 2005 we developed a new technique of arthroscopic rotator cuff repair: the double anchor footprint fixation (DAFF) technique, and then completed the current DAFF technique in 2006. It was characterized by briding-suture technique and no medial row knot, similar to transosseous fixation technique. The purpose of this study was to assess and compare the structural outcome of the DAFF with the DR for medium to large RCTs by MR imaging. We investigated 41 shoulders performed ARCR by two techniques, 18 by the DR and 23 by the DAFF. The average age at the operation was 63 years. In the DR, there were large RCTs in 4 shoulders and medium in 14.In the DAFF, large in 8 and medium in 15. The MRI assessment at 6 months postoperatively was performed on repair integrity using Sugaya's classifications. In the DR group, type I was detected in 2 shoulders, type II in 7, type III in 5, and type IV in 4. On the other hand, in the DAFF group, type I was in 6, type II in 14, type III in 2, type IV in 1 respectively. Type V was none in both. The rate of re-tear was 22% in the DR, 4% in the DAFF. Failure cases consisted of 2 medium-size RCTs treated by the DR, 2 large-size by the DR, and one large-size by the DAFF. Re-tear rate of the DAFF for medium to large RCTs is lower than that of the DR. In conclusion, the structural outcome of the DAFF technique that never needed medial-row knots was successful.