外傷性肩関節前方不安定症に対する Bankart 法の術前・後の関節症 : 術後5-20年の追跡調査の解析

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163 patients (167 shoulders) with the Bankart operation were investigated for presence of osteoarthrosis by preoperative CT, XP and postoperative XP at follow-up, and causes of the osteoarthrosis were analyzed by ages, periods, number of recurrent dislocations, size of bone defect of anterior glenoid and restriction of ROMs. The average age at first dislocation was 18years old (range, 7 to 29yeares old), at operation was 22years old (range, 14 to 34years old), and at follow-up was 31years old (range, 21 to 42years old). Osteoarthrosis existed in 44 shoulders by preoperative CT, which included 12 shoulders (7.2%: 12/167) by preoperative XP, and in 30 shoulders by postoperative XP. 167 shoulders were classified into the following five groups: postoperative occurrence group which were only detected by postoperative XP in 6 shoulders, progress group which were detected by preoperative CT and postoperative XP in 12, preoperative occurrence group which were detected by preoperative CT, XP and postoperative XP in 12, non-progress group which were only detected by preoperative CT in 20, and non-occurrence group in 117. Statistical analysis showed 30 shoulders with osteoarthrosis by postoperative XP had more frequent preoperative dislocations and large bone defects than the remaining 137 shoulders. Osteoarthrosis developed postoperatively had a low rate (4.9%: 6/167-44) and was related to the preoperative large number of recurrent dislocations and large bone defect. It is thought that a basic cause of the osteoarthrosis is in preoperative condition. Although Bankart operation could not prevent development of osteoarthrosis, the operation itself may not promote progress of osteoarthrosis.
日本肩関節学会の論文
2008-06-30

外傷性肩関節前方不安定症に対する Bankart 法の術前・後の関節症 : 術後5-20年の追跡調査の解析

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