初回発症が40歳以上の反復性肩関節前方脱臼の病態

概要

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We report the clinical features of anterior shoulder instability for patients more than 40 years old at initial injury. The subjects were 10 patients that consisted of 5 without cuff tears (group A1) and 5 with cuff tears (Group A2). The age at the initial injury was 40 to 82 (mean: 60.4) years old. The age at the time of surgery was 48 to 82 (mean: 67.5) years old. All 10 patients had traumatic anterior dislocation at initial injury and had recurrent dislocation only. No patient had a mixed recurrence of dislocation and subluxation or recurrent subluxation only. During arthroscopic procedure, Bankart lesions were found in all of the patients of Group A1. In these patients, type 2 SLAP lesions were noted in one patient and communicated to Bankart lesion. On the other hand, in Group A2 with cuff tears, Bankart lesions were found in only two patients. Of the 10 patients, no patient developed subluxation or dislocation after surgery. However, in Group A2, two patients had pain with motion. Patients more than 40 years old at initial injury had recurrent dislocation only, with no subsequent signs of subluxation.