抄録
We reviewed the cases of 44 patients with 45 tears of the rotator cuff which had been surgically repaired. The average age at the time of operation was 59.8 years(range 40 to 76 years). An anterior acromioplasty was performed on all the cases. McLaughlin's method was used in 34 shoulders, whereas side-to-side suturing was applied in nine, advancement of the supraspinatus in one and a graft of the fascia lata in one.
All the patients had an eary rehabilitation program within one week after surgery for their rotator cuff repair, using a continuous cervical epidural anesthesia(CE)or non-steroid anti-inflammatory drugs (NSAIDs). CEs were done pre-, intra-and postoperatively in 41 cases, for 27 of which a CE was also used for rehabilitation for one to three weeks at the longest. In the remaining cases, pain was controled only with NSAIDs. Passive elevation was started within two days to one week, and active elevation within three to four weeks. The postoperative results were assessed according to the scoring system of the Japanese Orthopedic Association(JOA score).
The total JOA scores were significantly higher with 65.0 before the operation,81.5 in the third month and 93.1 in the sixth month (p<0.01), and later staying on a plateau with 94.1 in the ninth month,96.0in the twelfth month,94.8 in the eighteenth month and 97.1 in the twenty-fourth mouth after surgery.
With the cooperation of anesthesiologists, we performed pain control primarily with CEs and started exercises within one week to obtain favorable results.
