肩腱板断裂に対するブリッジングスーチャーを用いた鏡視下修復術

Arthroscopic Rotator Cuff Repair Using Bridging Sutures

　鏡視下腱板修復術は，腱板付着部の内外2列にスーチャーアンカーを配して腱板を固定する重層固定法の導入により成績が飛躍的に向上した．しかし重層固定法にもいくつか弱点が指摘されており，それを補う方法としてブリッジングスーチャーを用いて修復腱板をより広範囲かつ強固に腱板付着部に圧着する方法が考案されている．本邦で使用可能な押し込み式のアンカーであるTAG-RodⅡアンカーを用いた鏡視下腱板修復術に関して紹介した．

　Arthroscopic double-row repair has become the standard method of surgery for rotator cuff tears, but disadvantages of double-row rotator cuff repair, including tension-mismatch between the medial row and lateral row, anchor failure due to osteopenia at the site of the lateral row, excessive stress on the medial row, and non-uniform pressure on the footprint, have been pointed out. I described achievement of a small improvement by securely pressing the cuff against its footprint by bridging sutures with TAG-Rod anchors. It is possible to decorticate the footprint aggressively and expose cancellous bone, and it is also possible to allow more effective pressurization of the tendon to its footprint by means of bridging sutures. As a result, improvement in the clinical and anatomic result will be achieved by using this method, and better tendon-to-bone healing can be expected.