石灰沈着性腱板炎に対する鏡視下石灰沈着除去術の有用性

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Calcifying tendinitis is classified to 3 phases: acute, subacute and chronic, according to the severity and the period from the onset of the disease. Conservative treatment is usually effective in acute and subacute phases; calcification and symptoms disappear during the natural course of this disease. However, calcification does not disappear and chronic shoulder pain remains in chronic phases in some cases. Currently a novel technique: arthroscopic calcification removal was reported in some literature. The aim of this study was to evaluate the clinical results of arthroscopic calcification removal for calcifying tendinitis with a minimum follow-up of 6 months. We retrospectively evaluated 20 shoulders in 20 patients (10 males and 10 females), who were diagnosed as chronic phase calcifying tendinitis and received arthroscopic calcification removal. The average age at the time of the surgery was 59.8 years old(43-83 years old). The average post-surgical follow-up was 20.7 months (7-46 months). We examined calcification and rotator cuff disease with X-ray, 3D-CT and MRI. Clinical results were evaluated using the JOA scores. Active range of motion of flexion and abduction were also evaluated. The average active flexion improved from 148.5 degrees preoperatively to 159.0 and 167.5 degrees at 3 and 6 months follow-up respectively. The average active abduction improved from 134.5 degrees preoperatively to 151.5 and 160.0 degrees at 3 and 6 months follow-up respectively. The average JOA score improved from 64.4 points preoperatively to 86.9 and 93.9 points at 3 and 6 months follow-up respectively. Additional arthroscopic rotator cuff repair surgeries were performed in 10 cases. We observed a complete calcification removal in 19 of 20 cases (95%) and no recurrence of calcification during the follow-up period. Patients treated with arthroscopic calcification removal for calcifying tendinitis have showed excellent clinical outcomes at a minimum of 6 months follow-up.
日本肩関節学会の論文

石灰沈着性腱板炎に対する鏡視下石灰沈着除去術の有用性

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