抄録
Background: Rotator cuff tears are common orthopedic injuries. However, their arthroscopic treatment can be technically challenging, especially for massive tears. In this study, we describe the therapeutic results of arthroscopic procedure for rotator cuff massive tears.
Methods: The subjects were 35 patients (20 males and 15 females). The age at the initial surgery was 49 to 78 (mean: 66.8) years old. According to the preoperative MR images, they were divided into three groups; group A (cuff tear involving SSP and ISP) in 13 patients (3 patients associated with rupture of LHB), group B (cuff tear involving SSP and SSC) in 3 patients, and group C (cuff tear involving SSP, ISP, and SSC) in 18 patients (3 patients associated with rupture of LHB). Of the 35 patients, we could achieve a direct repair of tendon to bone in 24 patients, complete repair. Also, we performed tenodesis of the LHB on the biceps groove in 12 patients with subluxation of LHB or partial repair of rotator cuff. The therapeutic results were evaluated according to the JOA score (80 points except radiographic findings and joint instability).
Results: The mean shoulder functions evaluated by JOA score were improved from 37.7(14 ∼ 61)points preoperatively to 69.4(25 ∼ 80)points postoperatively. There was no significance between the complete repair group (24 patients: 70.2 points) and the partial repair group (11 patients: 67.4) at final follow up.
Conclusion: Considering the therapeutic results of arthroscopic treatment for rotator cuff massive tears, there was no significance in the location of the cuff tear, in whether it was a reparable cuff tear or not, or in the treatment of LHB lesions, or in the occurrence of osteoarthritic changes between reparable cuff tears and irreparable cuff tears.
