腱板全層断裂の非手術例に対する保存療法の有効性

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We studied the effectiveness of conservative treatment in non-operative patients with full-thickness tear of the rotator cuff. There were 28 patients (30 shoulders) with an average age of 65 years old. Non-operative treatment consisted of rehabilitation and injection of H.A or steroid to the subacromial bursa. The average follow-up period was 19 months. Relationships between tear size, pain score, range of motion, and muscle strength were evaluated retrospectively. 1) 2 shoulders after massive tears scored with less than 80 points of JOA score at final follow-ups. 2) The average pain score improved significantly from 11 to 25. 3) The average ROM for elevation and external rotation improved from 110 to 128 degrees and 42 to 52 degrees, respectively. 4) In 6 shoulders with global or massive tears, muscle strength did not exceed 4 degrees; in this group satisfactory improvement was not obtained. 5) The average number of injections was 4.3. Patients with initial ROM limitations showed significant improvements if 120 degrees of elevation were obtained and/or the H.A. or corticosteroid was injected at least 4 times. Conservative treatment in non-operative patients with full-thickness tear of rotator cuff produced satisfactory results especially in regard to relief of pain. Patients with global or massive tears and muscle weakness did not experience a full recovery. 4 injections and 120 degrees of elevation were thought to be useful end-point indices for deciding on the effectiveness of conservative therapy.
日本肩関節学会の論文

腱板全層断裂の非手術例に対する保存療法の有効性

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