難治性拘縮肩での鏡視下Rotator Interval releaseの疼痛緩和効果

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Stiffness is a consistent but nonspecific symptom of primary frozen shoulder. Theories and descriptions of the lesions have varied over time and across authors, with the main target of the pathological condition being reported as the rotator interval (RI). We postulated the RI was related with the origin of pain. Arthroscopic capsulotomy has provided promising results in patients with persistent stiffness. However, there is little known about the significance of RI release during arthroscopic capsulotomy. The aim of this study was to evaluate the significance of RI release in a primary frozen shoulder, for pain relief and acquirement of shoulder motion. A prospective study was undertaken of 37 patients (24 males and 13 females) with frozen shoulder syndrome who were treated with an arthroscopic capsulotomy including RI release or not. 25 cases were treated with RI release (the plus group) and 12 cases were treated without RI release (the minus group). All of the patients were assessed for pain and range of motion before surgery and were monitored through to 6-months follow up. Improvement in symptoms of shoulder rest pain and night pain were measured by visual analog scale (VAS) at 3, 7 days and 1, 3, 6 months postoperatively. Clinical results were evaluated using the Japanese Orthopaedic Association shoulder scoring system (JOA score). A significant improvement in JOA score was observed in the plus group compared to the minus group at 3 months postoperatively. VAS at rest and at night was significantly decreased in the plus group than in the minus group at 7 days postoperatively. This study demonstrated that arthroscopic capsulotomy with RI release was an effective technique in the management of the frozen shoulder.
日本肩関節学会の論文

難治性拘縮肩での鏡視下Rotator Interval releaseの疼痛緩和効果

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