Yamaguchi Hiroshi, Suenaga Naoki, Oizumi Naomi, Hosokawa Yoshihiro, Kanaya Fuminori
Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
Adv Orthop. 2012;2012:195876. doi: 10.1155/2012/195876. Epub 2012 Jan 12.
Recently, retear rate after repair for massive cuff tear have been improved through devised suture techniques. However, reported retear rate is relevant to preoperative atrophy and fatty degeneration. The purpose of this study was to investigate whether preoperative atrophy and fatty degeneration of rotator cuff muscles improve by successful repair. Twenty-four patients with massive rotator cuff tear were evaluated on the recovery of atrophy and fatty degeneration of supraspinatus and infraspinatus muscle after surgery. Atrophy was classified by the occupation ratio and fatty degeneration by modified Goutallier's classification. Both were assessed on magnetic resonance imaging (MRI) before and after the operation. When the cuff was well repaired, improvement of the atrophy and fatty degeneration were observed in a half and a one-fourth of the cases, respectively. In retear cases, however, atrophy and fatty degeneration became worse. Improvement of atrophy and fatty degeneration of the rotator cuff muscles may be expected in the cases with successful achievement of rotator cuff repair for large and massive tear.
近年来,通过改进缝合技术,巨大肩袖撕裂修复后的再撕裂率有所改善。然而,报道的再撕裂率与术前萎缩和脂肪变性有关。本研究的目的是调查肩袖成功修复后,肩袖肌肉的术前萎缩和脂肪变性是否会得到改善。对24例巨大肩袖撕裂患者术后冈上肌和冈下肌萎缩及脂肪变性的恢复情况进行评估。萎缩按占有率分类,脂肪变性按改良的Goutallier分类法分类。两者均在手术前后通过磁共振成像(MRI)进行评估。当肩袖修复良好时,分别有一半和四分之一的病例观察到萎缩和脂肪变性有所改善。然而,在再撕裂病例中,萎缩和脂肪变性变得更严重。对于大型和巨大肩袖撕裂,成功完成肩袖修复的病例可能会出现肩袖肌肉萎缩和脂肪变性的改善。