関節包側腱板不全断裂に対する保存的治療の選択基準

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We assessed the clinical results and findings of joint-sided partial thickness tear (PTT) of rotator cuff treated by conservative treatment to clarify the criteria of indication for conservative PTT treatment. We studied 84 patients, of 47.6 years old mean age, who had been diagnosed with joint sided PTT and treated using a conservative treatment. Their mean UCLA score at the initial visit was 22.5 points. It was 30.1 after 6 months conservative treatment. We defined the top 25 cases of UCLA score after 6 months conservative treatment as the "Good group" and the bottom 25 cases as the "Poor group". Inter-group differences were tested for statistical significance according to medical history, clinical findings (range of motion: ROM, muscle strength, UCLA score), and tear length, the location and size of PTT before treatment. No significant differences were found between the groups in either medical history or muscle strength at the initial visit. External rotation in the 2nd position at the initial visit in the Good group were higher than that in the Poor group ( P<005). The total score, pain and function item of the UCLA score at the initial visit for the Good were higher than for the Poor ( P<0.05). The length of tear in the Poor group was longer than in the Good group ( P<0.05). Significantly more cases with a PTT of supraspinatus tendon occurred in the Poor group ( P<0.05). Box plot graph indicated that if maximal tear length rate was larger than 0.2, total score of UCLA score was lower than 24 points, which 75% of Poor group was contained. It is considered that a good result for joint-sided PTT is expected from conservative treatment if these criteria are not met.
2009-07-27

関節包側腱板不全断裂に対する保存的治療の選択基準

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