Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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회전근 개 파열 봉합술 후 재파열 환자에서 임상결과와 원인 인자

Clinical Outcome and Causative Factor in Patients of Structural Failure after Rotator Cuff Repair

  • 전재명 (울산대학교 서울아산병원 정형외과학교실) ;
  • 송정석 (울산대학교 서울아산병원 정형외과학교실) ;
  • 손동욱 (울산대학교 서울아산병원 정형외과학교실)
  • Chun, Jae-Myeung (Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Jung-Suk (Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sohn, Dong-Wook (Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2008.06.15
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초록

목적: 회전근 개 파열의 개방적 봉합술 후 임상적 결과와 회전근 개 연속성의 연관성을 알아보고 재파열 발생의 요인을 분석하고자 하였다. 대상 및 방법: 2004년부터 2006년까지 회전근 개 파열로 수술적 봉합술을 시행받은 78명의 환자를 대상으로 하였다. 모든 환자는 최소 1년 이상 추시하여 자기 공명 영상(MRI)을 촬영하고 재파열 유무를 확인하였다. 임상 결과는 재파열된 군과 유지된 군으로 나누어 평가하였다. 재파열의 원인 분석을 위해 수술전 파열의 크기, 유병 기간 등을 양군에서 비교하였다. 결과: 회전근 개 재파열군(n=22)의 수술후 임상결과는 수술전에 비하여 의미있게 호전되었으나(p<0.001, p<0.001). 근력은 수술후 의미있게 호전되지 않았다(p=0.099, p=0.243). 수술전 파열의 크기가 컸던 환자에서 재파열이 많았으며(p<0.001), 재파열된 군은 수술전 유병기간이 길었다(p=0.027). 결론: 회전근 개 개방적 봉합술 후 재파열이 되더라도 임상 결과는 호전되나 극상근과 외회전근의 근력은 의미있게 호전되지 않았다. 수술전 파열의 크기가 크고 유병 기간이 긴 경우에 수술후 재파열의 빈도가 높았다.

Purpose: We wanted to evaluate the relationship between the clinical outcomes and cuff integrity after open rotator cuff repair and we wanted to analyze the causes of rotator cuff retear. Materials and Methods: 78 patients who underwent open rotator cuff repair were enrolled from 2004 to 2006. All the patients were observed for a minimum follow-up of 12 months and they were evaluated by magnetic resonance imaging (MRI). The clinical outcomes were accessed by dividing the patients into the retear group and the intact group. The groups were also compared to analyze the cause of rotator cuff retear according to the preoperative tear size, the symptom duration, and so on. Results: The clinical outcome of the retear group (n=22) was improved significantly after operation (p<0.001, p<0.001), but the muscle power was not improved significantly (p=0.099, p=0.243). More retears were found in the patients who had a larger preoperative tear (p<0.001) and the symptom duration of the retear group was longer (p=0.027). Conclusion: Although there were retear after rotator cuff repair, the clinical outcomes were improved. Yet the muscle power of the supraspinatus and external rotator were not improved significantly. There were more retears for the cases that had a larger preoperative tear size and a longer duration of symptoms.

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참고문헌

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  1. The Effect of Different Starting Periods of Passive Exercise on the Clinical Outcome of Arthroscopic Rotator Cuff Repair vol.17, pp.2, 2014, https://doi.org/10.5397/cise.2014.17.2.57
  2. Patterns of Retear After Repair of the Rotator Cuff - MRI Analysis of 109Cases - vol.15, pp.1, 2012, https://doi.org/10.5397/CiSE.2012.15.1.24
  3. Risk Factors for Retear After Arthroscopic Repair of Full-Thickness Rotator Cuff Tears Using the Suture Bridge Technique: Classification System vol.32, pp.11, 2016, https://doi.org/10.1016/j.arthro.2016.03.012
  4. MRI Follow-up Study After Arthroscopic Repair of Multiple Rotator Cuff Tendons vol.11, pp.2, 2008, https://doi.org/10.5397/CiSE.2008.11.2.096