腱板広範囲断裂術後再断裂例に対して人工骨頭置換術と同時に腱板の再建術を施行した1例

Shoulder Hemiarthroplasty for a Massive Postoperative Rotator Cuff Tear. Case Report

　腱板広範囲断裂術後再断裂例では，腱板の縫合を行っても再断裂を来す可能性が高く，疼痛の残存，筋力回復不良，関節症の進行などのため治療法に難渋する場合が多い．今回われわれは，腱板広範囲断裂に鏡視下腱板修復術施行後に転倒し再断裂を来した症例に対し，保存療法および鏡視下滑膜切除を行うも改善しなかったため，人工骨頭置換術と同時に腱板の再建術を行い，短期ではあるが良好な成績が得られた1例を経験したので報告する．関節症を伴う一次縫合不能な広範囲断裂例や再断裂例などに対しては，人工骨頭置換術は有用な治療法の選択の一つであると考えた．

　Treatment of postoperative a massive rotator cuff tear as a result of a rerupture, is difficult because of decreased muscle strength, persistent pain, and progression to arthrosis.　We report a case in which hemiarthroplasty was performed to treat a massive postoperative rotator cuff tear after arthroscopic rotator cuff repair and arthroscopic synovectomy.　Good results were obtained, although the follow-up period has been short.　Hemiarthroplasty is one method of treatment for a rotator cuff tear that is impossible to repair in patients with arthrosis and for rerupture of a rotator cuff tear that has been repaired.