抄録
Background: We developed a new rotator cuff repair technique combined with muscle advancement for irreparable massive rotator cuff tear. In this study, we evaluated the clinical results and investigated the limitation of this procedure.
Methods: 14shoulders in 13patients with massive rotator cuff tear underwent the procedure. The mean age at operation was 65.6 years old and mean follow-up period was 27.2months. After a short skin incision was made on the scapular spine, medial detachment and advancement of the supraspinatus(SSP) and infraspinatus(ISP) muscle was performed. The torn cuffs were repaired using suture anchors( 10 shoulders in arthroscopic, 4 shoulders in open procedure). We evaluated the clinical results by JOA score. The cuff repair integrity was assessed by Sugaya's MR classification. Fatty degeneration of the cuff was graded on Y-shaped view of the preoperative MRI according to Goutallier's classification. GFDI(global fatty degeneration index) was calculated as the mean value of SSP, ISP and subscapularis(SSC) muscles.
Results: The average JOA score improved from 60.4 points to 92.8 points. AS for the repair integrity using Sugaya's classification, there were 3 type I shoulders, 3 type II, 1 type III , 2 type IV and 5 type V. The mean GFDI in the repaied group was 1.9, whereas that in the re-tear group was 2.7.
Conclusion: Rotator cuff repair combined with muscle advancement for massive tear provides satisfactory clinical outcomes. To prevent re-tear, careful consideration is required before surgery on a cuff tear that represents GFDI over 2.
