Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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다발성 회전근 개 파열에서 시행한 관절경적 회전근 개 복원술 후 MRI 추적 검사

MRI Follow-up Study After Arthroscopic Repair of Multiple Rotator Cuff Tendons

  • 태석기 (동국대학교 일산병원 정형외과학교실) ;
  • 김진영 (동국대학교 일산병원 정형외과학교실) ;
  • 박재식 (동국대학교 일산병원 정형외과학교실)
  • Tae, Suk-Kee (Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital) ;
  • Kim, Jin-Young (Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital) ;
  • Park, Jae-Sik (Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital)
  • 발행 : 2008.12.15
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초록

목적: 다발성 건을 침범한 관절경적 회전근 개 복원 술 후 재 파열의 발생률 및 관련된 요인을 알아 보고자 하였다. 대상 및 방법: 극상건과 극하건을 포함한 회전근 개 파열을 보인 22예의 관절경적 복원 술 후(평균 파열크기 3.2 cm, 평균 연령: 58세) 평균 10개월 후 자기공명영상으로 조사 하였다. 복원된 건의 상태 평가는 Sugaya의 분류를 이용하였으며 근육의 상태 변화는 Goutallier의 등급을 이용하였다. 결과: 총 22예 중 7예(32%)에서 재파열을 보였다(Sugaya 분류 IV, V형). 3 cm이상의 파열에서 높은 재파열률 을 보였으며(67%) 반면 3 cm 이하에서는 8%의 재파열률 을 보였다. 재파열을 보인 경우 수술 후 Goutallier II등급 이상의 근육의 변성을 보였다. 반면 재파열이 발생하지 않은 군에서도 근 위축이 호전된 경우는 볼 수 없었다. 결론: 다발성 건을 침범한 회전근 개 파열에서 관절경 적 복원 술 후 32%의 재파열을 보였다. 파열의 크기가 재파열의 중대한 요소이며 파열의 크기가 3 cm 이상인 경우 재파열이 더 자주 발생하였다. 재파열을 보인 경우 근 위축은 진행 하였으며 복원상태가 유지 되어도 근 위축이 호전된 경우는 볼 수 없었다.

Purpose: This study investigated the rate of retear and related factors after arthroscopic repair of rotator cuff tears involving more than one tendon. Materials & Methods: Arthroscopic repair of 22 rotator cuff tears (average size 3.2cm: average age 58 years old) involving the supraspinatus and part or all of the infraspinatus were investigated using MRI on average 10 months after repair. The status of the repaired cuff was investigated using Sugaya's classification, and the change in muscle was evaluated with Goutallier's classification. Results: Retear (Sugaya grade IV, V) was found in 7cases(32%). Tears larger than 3cm had a higher retear rate(67%) than smaller tears(8%). Retear cases had Goutallier grade II or higher muscle changes preoperatively and showed aggravation of muscle atrophy postoperatively. Even without retear, reversal of muscle change was not seen Conclusion: Rotator cuff tears not confined to the supraspinatus had a 32% retear rate after arthroscopic repair. The size of the tear was the most crucial factor influencing retear. Retear was frequent in tear over 3cm. Atrophy of the cuff muscle worsened when the repair failed but did not improve even without retear.

키워드

참고문헌

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피인용 문헌

  1. Deltoid muscle volume affects clinical outcome of reverse total shoulder arthroplasty in patients with cuff tear arthropathy or irreparable cuff tears vol.12, pp.3, 2017, https://doi.org/10.1371/journal.pone.0174361
  2. Isokinetic Muscle Strength and Muscle Endurance by the Types and Size of Rotator Cuff Tear in Men vol.17, pp.4, 2014, https://doi.org/10.5397/cise.2014.17.4.166