Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Short-term Outcomes of Arthroscopic Transtendinous Repair in Partial Articular Side Tears of the Rotator Cuff

회전근 개 부분 관절측 파열에 대한 관절경적 경 건 봉합술의 단기 결과

  • Shin, Sung-Ryong (Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, College of Medicine) ;
  • Yoo, Yon-Sik (Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, College of Medicine) ;
  • Kim, Do-Young (Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, College of Medicine) ;
  • Lee, Sang-Soo (Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, College of Medicine) ;
  • Jeong, Un-Seob (Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, College of Medicine) ;
  • Choi, Hyun-Seok (Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, College of Medicine)
  • 신성룡 (한림대학교 의과대학 춘천성심병원 정형외과학교실) ;
  • 유연식 (한림대학교 의과대학 춘천성심병원 정형외과학교실) ;
  • 김도영 (한림대학교 의과대학 춘천성심병원 정형외과학교실) ;
  • 이상수 (한림대학교 의과대학 춘천성심병원 정형외과학교실) ;
  • 정운섭 (한림대학교 의과대학 춘천성심병원 정형외과학교실) ;
  • 최현석 (한림대학교 의과대학 춘천성심병원 정형외과학교실)
  • Published : 2008.12.15
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Abstract

Purpose: This study prospectively evaluated the outcome of arthroscopic transtendinous repair as a treatment for partial articular side tears of the rotator cuff. Materials and Methods: Fifteen patients with symptomatic, partial articular side tears of the rotator cuff underwent modified transtendinous repair. The patient's mean age was 52.5 years and the mean duration of symptoms was 33.7 weeks. The visual analogue scale (VAS), the ASES score, the active ROM of the shoulder and the patient's satisfaction were evaluated both preoperatively and postoperatively. The clinical results were analyzed using the Wilcoxon's signed rank test. Results: The mean VAS was $6.6\pm1.1$ before treatment and $0.4\pm0.6$ at 6 month, and the ASES scores for all the patients were significantly better over the six-month period of follow-up (p<0.05). The mean active ROM in abduction was $94.3\pm22.3$ before treatment, $108.7\pm16.3$ at 1 month (p=0.0041) and $164.3\pm5.3$ at six months (p=0.0006). In flexion, it was $105.0\pm23.8$ before treatment, $119.0\pm17.4$ at 1 month(p=0.0075) and $174.3\pm5.3$ at six months (p=0.0006). At the final follow-up, 94% of patients were satisfied or very satisfied after operation. Conclusion: We experienced satisfactory clinical results after a short-term follow-up of arthroscopic transtendinous repair, and we believed this to be an effective procedure for patients with partial articular side tears of the rotator cuff.

목적: 회전근 개 부분 관절측 파열의 치료로 관절경적 경 건 봉합술을 시행하고 전향적으로 임상 양상을 비교 연구하고자 하였다. 대상 및 방법: 증상이 있고 자기 공명 영상과 관절경 소견에서 회전근 개 부분 관절측 파열로 관절경적 경 건 봉합술을 시행한 15예를 대상으로 하였다. 평균 연령은 52.5세였고, 평균 이환 기간은 33.7주였다. 수술 전, 후의 통증에 대한 시각 점수 척도(VAS), ASES 점수, 능동 관절운동 범위를 측정하여 임상기능 척도를 평가하였고, 최종 추시때 주관적 만족도를 조사하였다. 임상적 결과는 Wilcoxon's signed rank test를 이용하여 비교 분석하였다. 결과: 평균 VAS 점수는 수술 전 $6.6\pm1.1$점이었고 수술 후 6개월에 $0.4\pm0.6$점으로 감소하였으며, ASES 점수는 수술 후 6개월 추시 결과에서 수술 전에 비해 의미있게 증가하였다(p<0.05). 평균 능동 관절운동 범위는 외전의 경우 수술 전 $94.3\pm22.3$도에서 수술 후 1개월 때부터 의미있게 증가하여 $108.7\pm16.3$도였고(p=0.0041), 수술 후 6개월에는 $164.3\pm5.3$도로 증가하였다(p=0.0006). 전방 굴곡은 수술 전 $105.0\pm23.8$도, 수술 후 1개월에 $119.0\pm17.4$도였고(p=0.0075), 수술 후 6개월에는 $174.3\pm5.3$도였다(p=0.0006). 94%의 환자들이 최종 추시때 만족 이상의 결과를 나타냈다. 결론: 관절경적 경 건 봉합술은 단기 추시상 만족할만한 임상적 결과를 보였으며, 회전근 개 부분 관절측 파열 환자에 효과적인 치료 방법으로 생각된다.

Keywords

References

  1. Budoff JE, Nirschl RP and Guidi EJ: Debridement of partial-thickness tears of the rotator cuff without acromioplasty. Long-term follow-up and review of the literature. J Bone Joint Surg Am, 80: 733-748, 1998.
  2. Cordasco FA, Backer M, Craig EV, Klein D and Warren RF: The partial-thickness rotator cuff tear: is acromioplasty without repair sufficient?. Am J Sports Med, 30: 257-260, 2002.
  3. Deutsch A: Arthroscopic repair of partial-thickness tears of the rotator cuff. J Shoulder Elbow Surg, 16: 193-201, 2007. https://doi.org/10.1016/j.jse.2006.07.001
  4. Ellman H: Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop, 254: 64-74, 1990.
  5. Gonzalez-Lomas G, Kippe MA, Brown GD, Gardner TR, Ding A, Levine WN and Ahmad CS: In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears. J Shoulder Elbow Surg, 17: 722-728, 2008. https://doi.org/10.1016/j.jse.2008.01.148
  6. Ide J, Maeda S and Takagi K: Arthroscopic transtendon repair of partial-thickness articular-side tears of the rotator cuff: anatomical and clinical study. Am J Sports Med, 33: 1672-1679, 2005. https://doi.org/10.1177/0363546505277141
  7. Lehman RC and Perry CR: Arthroscopic surgery for partial rotator cuff tears. Arthroscopy, 19: E81-84, 2003. https://doi.org/10.1016/S0749-8063(03)00692-3
  8. Lo IK and Burkhart SS: Transtendon arthroscopic repair of partial-thickness, articular surface tears of the rotator cuff. Arthroscopy, 20: 214-220, 2004. https://doi.org/10.1016/j.arthro.2003.11.042
  9. Mazzocca AD, Rincon LM, O'Connor RW, Obopilwe E, Andersen M, Geaney L and Arciero R: Intraarticular partial-thickness rotator cuff tears: Analysis of injured and repaired strain behavior. Am J Sports Med, 36: 110-116, 2008.
  10. Millstein ES and Snyder SJ: Arthroscopic management of partial, full-thickness, and complex rotator cuff tears: indications, techniques, and complications. Arthroscopy, 19(Suppl 1): S189-199, 2003. https://doi.org/10.1016/j.arthro.2003.10.033
  11. Waibl B and Buess E: Partial-thickness articular surface supraspinatus tears: a new transtendon suture technique. Arthroscopy, 21: 376-81, 2005. https://doi.org/10.1016/j.arthro.2004.11.008
  12. Weber SC: Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy, 15: 126-131, 1999. https://doi.org/10.1053/ar.1999.v15.0150121

Cited by

  1. Outcome Comparison Between in Situ Repair Versus Tear Completion Repair for Partial Thickness Rotator Cuff Tears vol.31, pp.11, 2015, https://doi.org/10.1016/j.arthro.2015.05.016