Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Primary Repair in Tears Affecting Two or More Rotator Cuff Tendons

두 개 이상 건이 이환된 회전근 개 파열에서 일차 복원술

  • Kim, Jin-Young (Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital) ;
  • Kang, Ki-Ser (Department of Orthopaedic Surgery, Chung-Ang University Yong-San Hospital) ;
  • Tae, Suk-Kee (Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital)
  • 김진영 (동국대학교 일산병원 정형외과) ;
  • 강기서 (중앙대학교 용산병원 정형외과) ;
  • 태석기 (동국대학교 일산병원 정형외과)
  • Published : 2007.12.15
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Abstract

Purpose: The current study assessed the factors affecting outcomes of primary repair procedures in tears of multiple rotator cuff tendons. Materials and Methods: Among the cases of rotator cuff tears involving two or more tendons receiving operations between 1997 and 2003, The clinical results of 19 cases with more than 2 years follow-up were evaluated by the UCLA score. We evaluated the correlation of trauma, active motion, acromiohumeral distance, tear size, and surface area with the UCLA score using Pearson's linear correlation coefficient (PLCC). Results: UCLA scores increased significantly in all cases, from 9 to 26.1 on average. However, the results were good in 53%, and poor in 47% according to Ellman's criteria. Trauma, active elevation, acromiohumeral distance, and tear size did not correlate with the UCLA score, but the tear surface area was inversely correlated with the score (PLCC=-0.696). Cases with degeneration of the infraspinatus muscle above Goutallier grade III on MRI showed worse results than cases with less degeneration. Conclusion: The clinical results of primary repair of rotator cuff tears involving multiple tendons were satisfactory in 53% of patients. Large tear surface area and severe degeneration of the infraspinatus were poor prognostic factors.

목적: 다발성 회전근 개 파열에서 일차 복원술의 결과와 결과에 영향을 주는 인자를 분석하고자 하였다. 대상 및 방법: 1997년에서 2003년 사이에 두 개 이상 건이 이환된 회전근 개 파열에 대하여 일차 복원술을 시행한 후 2년 이상 추시된 19예(평균 연령 64.8세)를 대상으로 UCLA score의 변화를 조사하고, 외상, 능동적 운동, 견봉-상완골간 간격, 파열의 크기, 면적 등과 UCLA score사이의 상관 관계를 Pearson 선형 상관계수(PLCC)를 이용하여 검증하였다. 결과: UCLA score는 평균 9.4에서 26.1로 전 예에서 뚜렷이 증가하였으나 Ellman 기준상 53%에서 우수, 47%는 불량의 결과를 보였다. 외상, 능동적 거상, 견봉-상완골 간격 및 파열의 크기는 UCLA score와 상관관계가 없었으나 파열 면적은 UCLA score와 역 상관관계가 있었으며(PLCC=-0.696) MRI상 극하근의 Goutallier등급 III단계 이상 변성이 있는 경우는 불량한 결과를 보였다. 결론: 다발성 회전근 개 파열에서 일차 복원술의 결과는 53%에서 만족스러웠다. 큰 파열 면적, 극하근의 심한 변성은 불량 예후인자로 사료된다.

Keywords

References

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