一次修復不能な腱板広範囲断裂に対する鏡視下肩峰下除圧術の治療成績

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We performed arthroscopic subacromial decompression (ASD) for an irreparable massive rotator cuff tear to allow low-activity elderly patients to elevate their shoulders. The purpose of this study was to evaluate the clinical results of ASD for an irreparable massive rotator cuff tear. We retrospectively studied 10 patients (10 shoulders) who had received ASD for an irreparable massive rotator cuff tear and were followed-up for more than 2 years. The patients were 4 males and 6 females. Their mean age at operation was 73 years old (range, 62-82). The mean postoperative follow-up period was 37 months (range, 24-65). Our operative indications were 1) irreparable massive rotator cuff tear 2) sedentary and elderly people 3) that pain was the chief complaint 4) who could elevate their arm if their pain was relief. The clinical results were assessed using the JOA scores and radiographic findings. The mean total JOA score was 90.4 points postoperatively compared to 62.2 points respectively improved from 9.0 to 27.5 (p=0.0045), 13.3 to 17.7 (p=0.0049), 22.3 to 28.4 points (p=0.0112) postoperatively. The mean acromiohumeral interval (AHI) decreased from 6.4mm to 2.5mm postoperatively (p=0.0029). Radiographic findings showed the progression of osteoarthritis (OA) in 5 patients who were followed-up over 35 months (p=0.0016). We cannot expect the total recovery of power using ASD for an irreparable massive rotator cuff tear. However, this procedure provides pain relief through minimal surgical invasion, and we can promote early rehabilitation. The total JOA score was improved, but radiographic findings showed the progression of OA and decreases in AHI. This procedure achieved good clinical results with limited indications, but further long term follow-up is necessary.
日本肩関節学会の論文

一次修復不能な腱板広範囲断裂に対する鏡視下肩峰下除圧術の治療成績

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