Takeda Hiroshi, Urata Setsuo, Matsuura Masaaki, Nakayama Akira, Yonemitsu Hiroyuki
Department of Orthopaedics, Kumamoto Kinoh Hospital, Kumamoto, Japan.
J Shoulder Elbow Surg. 2007 May-Jun;16(3):316-20. doi: 10.1016/j.jse.2006.10.001. Epub 2007 Apr 6.
We reattached the torn rotator cuff medial to the anatomic cuff insertion site if it was retracted. The purpose was to correlate the amount of medial reattachment of the cuff with shoulder function. We evaluated 63 shoulders in which repaired cuffs were followed with magnetic resonance imaging at a mean follow-up of 8 years. The amount of medial reattachment of the cuff tendon was determined by use of a T2-weighted oblique coronal view, which passed through the center of the humeral head, and was defined as the NCA angle (where N indicates the new cuff insertion point, C indicates the center of the humeral head, and A indicates the anatomic cuff insertion point). Theoretically, the more medially the cuff tendon was reattached, the greater the NCA angle. Neither the Japanese Orthopaedic Association shoulder score nor isometric strength of forward elevation was correlated with the NCA angle. The NCA angle was significantly correlated (P = .001) with the active forward elevation angle, which dramatically decreased at 30 degrees of the NCA angle, approximately 13 mm from the original cuff insertion point, assuming a humeral head radius of 25 mm.
如果撕裂的肩袖回缩，我们将其重新附着于解剖学肩袖附着点内侧。目的是将肩袖内侧重新附着的程度与肩部功能相关联。我们评估了63例肩部，对修复后的肩袖进行磁共振成像随访，平均随访时间为8年。通过使用穿过肱骨头中心的T2加权斜冠状位视图来确定肩袖肌腱内侧重新附着的程度，并将其定义为NCA角（其中N表示新的肩袖附着点，C表示肱骨头中心，A表示解剖学肩袖附着点）。理论上，肩袖肌腱重新附着得越靠内侧，NCA角越大。日本骨科协会肩部评分和前屈等长力量均与NCA角无关。NCA角与主动前屈角度显著相关（P = 0.001），假设肱骨头半径为25 mm，当NCA角为30度时，主动前屈角度显著下降，此时距原始肩袖附着点约13 mm。
