著者

林田 賢治 米田 稔 岡村 健司 広岡 淳 脇谷 滋之 妻木 範行

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.17, no.2, pp.315-319, 1993-09-01 (Released:2012-11-20)

参考文献数

8

被引用文献数

1

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To decide the appropriate treatment for articular-side partial rotator cuff tears (APRCT),31patients with arthroscopically documented APRCT were surgically treated and reviewed retrospectively. The mean age at time of operation was 31 years old (13-62) and the mean post-operative follow-up period was 22.5 months (12-66). APRCT was classified into three groups according to the depth of the cuff tear, the superficial tear (S-tear), the intermediate tear (I-tear), and the deep tear (D-tear).8 patients with a S-tear were treated by arthroscopic debridement of the lesion (S-tear &debridement group).23 patients had an I-tear.16 of them had an arthroscopic debridement of the lesion (I-tear & debridement group) performed of time, and 7 of them were treated by open repair procedure (I-tear & repair group).3 patients with a D-tear were treated by open repair procedure (D-tear & repair group). Arthroscopic or open subacromial decompression were simulteneously performed in all of the cases. The functional results were graded by Constant's shoulder rating scale (1987) which consisted of the evaluation of pain, function, range of motion, and strength of abduction. Clinical results were evaluated by the ratio of the rating scale; the involved side / the healthy side (%). Statistic significances were calculated by Student's t-test.According to the ratio of total clinical evaluation, the S-tear & debridement group was 99.3 +2.9%, the I-tear & debridement group was 97.4 + 4.4%, the I-tear & repair group was 87.3 + 7.7%, and the D-tear & repair group was 87.5 + 14.0%. There were no significant differences between the S-tear & debridement group to 2 and the I-tear & repair group to 4, but there was a significant difference between the I-tear & debridement group to the I-tear & repair group (p <0.01). The results of the strength of abduction were the S-tear & debridement group was 93.6 + 11.4%, the I-tear & debridement group was 98.4 + 18.7%, the I-tear & repair group was 78.6 + 11.2%, and the D-tear & repair group was 97.6 + 4.1%. A significant difference was also seen between the I-tear &debridement group to the I-tear & repair group (p <0.01).In this follow-up study, two things were clarified. Firstly, the clinical outcome of an arthroscopic debridement for APRCT was not influenced by the depth of a lesion with less than half of a rotator cuff thickness. Secondly, the arthroscopic debridement for an intermediate type APRCT with subacromial decompression provided a more favorable clinical outcome than did the open repair technique.