Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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회전개근 순수 관절경적 봉합술과 국소절개 구제봉합술 비교분석 : 2~6년 추시결과 분석

Arthroscopic Versus Mini-Open Salvage Repair of the Rotator Cuff Tear : Outcome Analysis at Two to Six Years Follow-up

  • 김승호 (성균관대학교 의과대학 삼성서울병원 정형외과) ;
  • 하권익 (서울 보훈병원 정형외과) ;
  • 박종혁 (성균관대학교 의과대학 삼성서울병원 정형외과) ;
  • 강진석 (성균관대학교 의과대학 삼성서울병원 정형외과) ;
  • 오성균 (성균관대학교 의과대학 삼성서울병원 정형외과) ;
  • 오일빈 (성균관대학교 의과대학 삼성서울병원 정형외과) ;
  • 유재철 (성균관대학교 의과대학 삼성서울병원 정형외과)
  • Kim, Seung-Ho (From the Department of orthopaedic Surgery, Sungkyunkwan University School of Medicine) ;
  • Ha, Kwon-lck (Samsung Medical Center Sheoul VeteransHospital) ;
  • Park, Jong-Hyuk (From the Department of orthopaedic Surgery, Sungkyunkwan University School of Medicine) ;
  • Kang, Jin-Seok (From the Department of orthopaedic Surgery, Sungkyunkwan University School of Medicine) ;
  • Oh, Sung-Kyun (From the Department of orthopaedic Surgery, Sungkyunkwan University School of Medicine) ;
  • Oh, Ir-Vin (From the Department of orthopaedic Surgery, Sungkyunkwan University School of Medicine) ;
  • Yoo, Jae-Chul (From the Department of orthopaedic Surgery, Sungkyunkwan University School of Medicine)
  • 발행 : 2002.12.01
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초록

The purpose of this study was to compare the outcomes between arthroscopir repair and mini-open repair of medium and large rotator cuff tears in which arthroscopic repair was technically unsuccessful. We evaluated 76 patients of full-thickness rotator cuff tears, among them 42 patients had all-arthroscopic and 34 patients had mini-open salvage repairs. Patients who had acromioclavicular arthritis, subscapularis tear, or instability were excluded. There were 39 males and 37 females with mean age of 56 years (range,42 to 75 years). At a mean follow-up of 39 months (range, 24 to 64 months), the results of both groups were compared with regard to the UCLA and ASES shoulder rating scale s. Shoulder scores improved in all ratings in both groups (p > 0.05). Overall, sixty-six patients showed excellent or gr)of and ten patients showed fair or poor scores by the UCLA scale. Seventy-two patients satisfactorily returned to prior activity. Four showed unsatisfactory return. The range of motion, strength, and patient's satisfaction were improved postoperatively. There were no difference in shoulder scores, pain, and activity return between the arthroscopic and mini-open salvage groups (p > 0.05). However, Patients with larger size tear showed lower shoulder scores and less predictive recovery of the strength and function (p < 0.05). Postoperative pain was not different with respect to the size of the tear (p : 0.251). Arthroscopic repair of medium and large full-thickness rotator cuff tears had iln equal outcome to technically unsuccessful arthroscopic repairs, which were salvaged by conversion to a mini- open repair technique. Surgical outcome depended on the size of the tear, rather than the method of repair.

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참고문헌

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