抄録
Background: The aim of this study was to elucidate the outcome of arthroscopic repair of large and massive rotator cuff tears without pain and with severe disability of elevation.
Methods: In this study, we evaluated 25 cases in which the preoperative JOA pain sub-score was more than 20 points and also preoperative active range of motion (ROM) in both anterior elevation and abduction was less than 90°. Fourteen cases were primary repaired, 2 cases were partial repaired, and 9 cases were repaired with fascia lata autograft. Pre and post-operative active ROM and JOA score were evaluated.
Results: The average active ROM of anterior elevation improved from 39.0° to 122.4°, and abduction improved from 37.5° to 117.0°. The average JOA score improved from 60.8 to 84.6. In JOA sub score, pain, function, activity of daily life (ADL), and ROM improved from 22.2, 1.3, 5.2, 12.1 to 27.2, 7.8, 9.1, 20.5, respectively. There were 3 cases with post-operative active ROM of both anterior elevation and abduction < 90°. There were some characteristics in those cases, the recovery of active ROM of external rotation arm at side was poor, subscapularis tendon tear was severe, and repair integrity was poor.
Discussion: The outcomes were good in most cases. The arthroscopic rotator cuff repair for large and massive tears without pain and severe disability of elevation were effective for recovery of elevation activity and ADL improvement. For further improvement of clinical results, the evaluation of pre-operative active external rotation ROM, and the efforts for good subscapularis tendon repair and fine repair integrity is considered to be important.
