Abstract
Patients with a large or massive tear of the rotator cuff were, when possible, treated with the McLaughlin procedure. A patch graft was used when it was impossible to perform this procedure. The patch group (group P) consisted of nine patients with nine shoulders (six men, three women) with a mean age of 62.8±6.9 years. The McLaughlin group (group M) consisted of 12 patients with 12 shoulders (ten men, two women) with a mean age of 52.3±8.6 years. Mean follow-up was 2 years 11 months in group P and 4 years 2 months in group M. Using the shoulder scoring system of the Japanese Orthopaedic Association (JOA score), the total score improved post-operatively in both groups. In group P, the post-operative score was 91.7 (pre-operative score 47.9) and in group M 92.0 (pre-operative score 54.2). Tears recurred in three shoulders within 2 months of the McLaughlin procedure, and these patients were excluded from the study. The rate of 're-tearing' was lower with a patch graft (0/13) than with the McLaughlin procedure (3/17).
Résumé
Des malades avec une large déchirure de la coiffe des rotateurs furent traités soit par le procédé de McLaughlin quand c'était possible soit par une greffe en patch. Le groupe avec greffe (groupe P) était constitué de 9 épaules chez 9 malades (6 hommes, 3 femmes) avec un âge moyen de 62.8±6.9 années. Le groupe McLaughlin (groupe M) comportait 12 épaules chez 12 malades (10 hommes, 2 femmes) avec un âge moyen de 52.3±8.6 années. Le suivi moyen était de 35 mois dans le groupe P, et 50 mois dans le groupe M. En utilisant le système de cotation de l'épaule de l'Association Orthopédique Japonaise (JOA score), le score total a été amélioré en postopératoire dans les deux groupes. Dans le groupe P le score postopératoire était 91.7 ( 47.9 avant l'opération) et dans le groupe M le score postopératoire était 92.0 ( 54.2 avant l'opération). Les déchirures ont récidivés dans 3 épaules dans les 2 mois suivant le procédé de McLaughlin et ces malades a été exclus de l'étude. Le taux de récidive était plus faible avec une greffe en patch (0/13) qu'avec la méthode de McLaughlin (3/17).
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Ito, J., Morioka, T. Surgical treatment for large and massive tears of the rotator cuff. International Orthopaedics (SICOT) 27, 228–231 (2003). https://doi.org/10.1007/s00264-003-0459-4
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DOI: https://doi.org/10.1007/s00264-003-0459-4