腱板広範囲断裂に対する鏡視下肩峰下除圧術の利点と欠点

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We reported on the clinical efficacy and limits of arthroscopic subacromial decompression (ASD) with intraarticular debridement for a massive rotator cuff tear. A chart review of 24 shoulders of 21 patients with a massive rotator cuff tear, all of them showed good elevation after a lidocaine injection into the subacromial bursa, and who were treated by ASD with intraarticular debridement was undertaken. The clinical outcome was measured by the Japanese Orthopedic Association Shoulder Score (JOA score). The average age of this study was 72.5 years old. All the patients showed good relief of night shoulder pain and an increase of the range of active shoulder elevation. 21shoulders of 19 patients were satisfied with the surgery because of pain relief. 3 shoulders of 3 were not satisfied. The reasons were, pain remaining in heavy work of a 64 year old woman, delicate difference of pain remission between bilateral shoulders of a 70 year old man who had undergone the same operation, and pain remaining on elevation with severe shoulder osteoarthritis of a 81 years old woman. In a massive rotator cuff tear patients showing good pain relief elevations after a subacromial bursal block, were those who did not need to work heavily, ASD with inatraarticular debridement provided good pain relief improvement of shoulder elevation.
日本肩関節学会の論文