肩鎖関節変形性関節症における鏡視下鎖骨遠位端切除術の有用性

概要

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The purpose of this study was to evaluate the clinical results of arthroscopic distal clavicle resection for the treatment of painful acromioclavicular (AC) joint osteoarthritis. We evaluated 17 shoulders of 17 patients, who had undergone arthroscopic distal clavicle resection with minimum three months follow-up. The average age at the time of surgery was 58.1 years old. Clinical evaluation was composed of 7 different items: duration of the symptom, cause of the disease, accompanied shoulder lesion, volume of the bone resection, tenderness of the AC joint, horizontal adduction test and postoperative complications. The average duration of the preoperative symptom was 31.0 months. Causes of the disease were overuse in 13 cases, post types I and II AC joint injury in 2 cases and other major traumatic events in 2 cases. Impingement syndrome was accompanied in all the cases. 14 cases of SLAP lesion, 11 cases of rotator cuff tears, and one case of LHB tear were observed. The average volume of distal clavicle resection was 12.8 (7 to 20) mm. Complete disappearance of AC joint tenderness was recognized in 11 cases; mild AC joint tenderness remained in 6 cases. No pain in the horizontal adduction test; all the patients were satisfied with the results without major complications. Our results showed arthroscopic distal clavicle resection is an effective surgical procedure for the treatment of painful AC joint osteoarthritis.
日本肩関節学会の論文