Okay, next papers is going to be presented by Dr. Mihata from Japan. It's going to be a minimum 10-year follow-up of arthroscopic superior capsular reconstruction for irreparable rotator cuff tears, graft survival rate, and progression of calf tear arthropathy. Thank you, Chair. My study is a long-term follow-up of HCR. And there are... That's it? Yeah, just to give you a clue. Okay, here's my disclosure. So, for irreparable rotator cuff tear, functional improvement and pain relief have been reported in the short-term outcome of HCR. In this study, we assess the if good outcome and graft are maintained at 10 years follow-up, and if calf tear arthropathy progresses over time after HCR. Forty-eight contacted patient with irreparable calf tear underwent arthroscopic HCR. Five died, five moved, and two had a severe health problem, and two refused to participate. So, the remaining 34 patients were enrolled in this study. For arthroscopic HCR, we always use a fascia-lateral autograft. And this study also, in all patients, we use the autograft fascia-lateral. And important thing, the six to eight-millimeter thickness of the graft to get a good outcome. Then after HCR, arthroscopic looks like the after rotator cuff repair, even irreparable calf tear before. And we evaluated in this study graft survival rate, approximate distance, active elevation, HCR score, and calf tear arthropathy, as well as radiation-gridded osteoarthritis. Results. Graft survival rate at three months after surgery, two patients had graft tear. And two years, one more patient, graft tear. And five years, two more patients, graft tear. But between five to 10 years, we did not see the graft tear. So, the final graft survival rate at 10 years after surgery is 89%. And accurate distance seemed to increase just after surgery, 3.5 to 10.3. Then gradually decreased, but even at 10 years after surgery, still good number, 8.2 millimeters. So, the wide accurate distance maintained at 10 years after surgery. And active shoulder elevation in healed patient, one year after surgery, significantly increased to 149. Then, after five years, gradually increased, averaged at 162. Then, even 10 years after surgery, good active shoulder elevation was maintained. But graft tear patient, different trend. Active elevation decreased with time. ACS score in healed patient also increased at one year after surgery to 90. Then, after five years, gradually increased to 96. Then, 10 years after surgery, still good ACS score was maintained. And even graft tear patient, one year after surgery, increased to 83 because of pain relief. And fortunately, at 10 years after surgery, the ACS score was maintained. But when we compare the healed patient to graft tear patient, actually, graft tear patient was 10-point loss because the function did not improve very well. And here's the rate of acerbalization in healed graft. It's 34% before surgery. And just after surgery, it decreased to zero because the old patient increased accurate distance. Then, 10 years after surgery, increased to 9%. But the other side also increased. And no significant difference between both shoulders. So, acerbalization at 10 years here results from the age. It's a great amount of osteoarthritis in healed graft is 6% before surgery. And just after surgery, no change. And 10 years after surgery, increased to 28%. But the other side also increased to 16%. And no significant difference between both shoulders. So, again, osteoarthritis at 10 years after surgery also results from the age. Graft tear patient, different. Before surgery, no acerbalization and no osteoarthritis in this study. But 10 years, 75% and 100%. So, graft tear progress after osteopathy at 10 years after SEO. Okay, back. Yeah, so, if the graft is healed 10 years after surgery, all patient had a good elevation and good function. Actually, they forget they did the surgery because they feel normal. So, the SEO is not for time-saving surgery. Actually, this is the final surgery. In conclusion, for ilper-road graft tear, arthroscopic SEO restores shoulder function and relieves shoulder pain with high rate of retentive support and physical work, and maintains significant improvement in clinical and structural outcome at 10 years after surgery. Graft healing completely prevented progression of catheter arthropathy after arthroscopic SEO. Thank you for attention. Thank you.

Dr. Mihata

arthroscopic superior capsular reconstruction

irreparable rotator cuff tears

graft survival rate

calf tear arthropathy