鏡視下除圧術を行った肩甲部 paralabral cyst の6症例

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The purpose of this study was to evaluate the clinical results after arthroscopic decompression for paralabral cysts. We retrospectively evaluated 6 cases (6 males) with paralabral cysts treated by arthroscopic decompression during the period between January, 2001 and May, 2008. Their mean age was 28 (23-42) years old. All cases had shoulder pain and 5 cases had weakness on external rotation and atrophy of the infraspinatus muscle. Preoperative MRI showed cystic lesions adjacent to the supraglenoid notches. Arthroscopic findings: Labral fraying was seen posterosuperiorly in 4 cases and at another area in 2 cases. The communication between cyst and joint was detected in 5 cases at the posterosuperior labrum. The posterosuperior capsule was protruded in 4 cases. Arthroscopic decompression: We performed enlargement of the communication in 1 case, the capsular release in 3 cases and both of these in 2 cases. In 2 cases, we sonographically confirmed the complete decompression during the operation. The symptoms were immediately relieved after the operation in all cases. No recurrence was found in MRIs. Cysts were successfully decompressed either by the communication enlargement or by the capsular release. Capsular protrusion could be more helpful in detecting cyst and communication than labral lesion. All 5 communications existed at the posterosuperior labrum. 1 of communications was not detected at labral injury area although labral injury was seen in all cases. On the other hand, in all 4 cases in which capsular protrusion was seen, communication existed near capsular protrusion. Moreover, cyst decompression was achieved easily by incision of protrusion. We suggest that paralabral cysts could be successfully treated with this arthroscopic decompression and that intraoperative sonography should assist in complete decompression especially in the cases of multiple cysts.
日本肩関節学会の論文
2009-07-27

鏡視下除圧術を行った肩甲部 paralabral cyst の6症例

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