肩峰下骨棘及び大結節の変化と断裂腱板の組織学的変性との関連

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The purpose of this study was to determine the correlation of acromial spur formation (ASF), degenerative change on the greater tuberosity (GT), and severity of degenerative alteration of the tendon in rotator cuff tears. 100 patients with rotator cuff tears (32 incomplete and 68 complete tears) found surgically were selected to examine the ASF, degenerative change on the GT on plain X-rays and correlate these findings with the severity of cuff degeneration. ASF was divided into 3 types (type I: no spur, type II: spur formation, type III: acromio-clavicular osteoarthrosis). ASF was not related to severity of cuff degeneration, AHI, LAA, age or duration of symptom. We observed an increased incidence of complete tears and traumatic episode in group of type II and increased incidence of type II in the patients with bursal side tears. ASF was also present in the patients with articular side tears. Degenerative change on the GT was correlated with AHI, severity of cuff degeneration, size of tears and age. However, ASF and traumatic episode were not related to the change on the GT. Histologic findings of ASF revealed the fibrosis with vascular proliferation, sclerotic change of the bone, and thickening of the fibrocartilage layer due to the mechanical stress or reactive bone formation. Degenerative change on the GT was associated with severity of cuff degeneration. ASF seems to be the secondary change after a rotator cuff tear since the incidence of a type II and histologic findings.
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