鏡視下鎖骨遠位端切除術を併用した鏡視下腱板縫合術の有用性

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The purpose of this study was to evaluate clinical outcomes of arthroscopic rotator cuff repair (ARCR) combined with distal clavicle resection for the treatment of rotator cuff tear and painful acromioclavicular (AC) joint osteoarthritis. We evaluated 25 shoulders of 24 patients (group I), who had undergone this combined arthroscopic surgery with a minimum of six months follow up. Average age at the time of surgery was 61.2 years old. Twenty five shoulders with only ARCR (group II) were evaluated as a control group. Clinical evaluation was composed of volume of the bone resection, tenderness of the AC joint, horizontal adduction test and postoperative complications. Surgical outcomes were evaluated by using the Japanese Orthopaedic Association (JOA) shoulder scoring system and statistically evaluated between the two groups. Average volume of distal clavicle resection was 10.3 (8 to 13) mm. Complete disappearance of AC joint tenderness was recognized in 23/25 shoulders; mild AC joint tenderness remained in 2/25 shoulders. No pain was observed in horizontal adduction test. All the patients were satisfied with surgical results without major complications. Preoperative average JOA score was 55.6 points and improved to 79.2 points at 3 months F/U and 86.6 points at 6 months F/U respectively in group I. Preoperative average JOA score was 55.9 points and improved to 79.3 points at 3 months F/U and 87.1 points at 6 months F/U respectively in group II. There was no significant difference between the two groups. Our results showed ARCR combined with distal clavicle resection was an effective surgical procedure for the treatment of combined lesions with rotator cuff tears and painful AC joint osteoarthritis.

鏡視下鎖骨遠位端切除術を併用した鏡視下腱板縫合術の有用性

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