2000 年 24 巻 3 号 p. 485-488
The purpose of this study was to evaluate the clinical results of reconstruction with PTFE felt augmentation for irreparable massive rotator cuff tears. Materials and methods: Thirty patients,24 men and 6 women, with irreparable massive rotator cuff tears who had undergone rotator cuff reconstruction with a PTFE felt augmentation more than 24months previously were investigated. The average age at the time of surgery was 64 years (range: 4476) and the mean follow-up period was 38 months (range.: 25-60). Clinical results were evaluated the JOA system of pain, function, motion, and total evaluation. Plain X-ray photographs were used to investigate whether bony changes existed. Results: Using the J. O. A system, the total score improved from an average of 57 points preoperatively to an average score of 82 points postoperatively. In particular, the average pain score improved significantly from 9.5 to 23.2 points.
The plain X-ray photographs revealed OA change in only one case, which had been present preoperatively. Enlargement of the bone gutter of the greater tuberosity were seen in nine cases(30%)after 12 months postoperatively.
After 6 months postoperatively, a subacromial busal infection in 1 patient which subsided after drainage and treatment with antibiotics.
Discussion: Reconstructio n of rotator cuff with a PTFE felt augmentation ofters the following advantages. It can substitute for the defects in a rotator cuff which may lead to the upward migration of the humeral head and aquire the subacromial space, but it might also induce the connective tissue to from among the PTFE fibers around the defect. On the other hand, PTFE felt is a foreign substance and its introduction into a living body presents the problem of any biological reaction. The enlargement of the bone gutter may be due to a biological reaction against the PTFE felt, so follow-up over a longer period is necessary.