腱板不全断裂に対し単独に鏡視下肩峰下除圧を施行した治療成績

概要

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Partial rotator cuff tears are very common, but little is known about the MRI findings after the sole arthroscopic subacromial decompression (ASD).<BR>We evaluated the clinical outcome and T2MRI findings after ASD in 57 patients with 59 shoulders who had partial rotator cuff tear. The average age was 57.0 years old. Clinical results were evaluated with Japanese Orthopaedics Association score (JOA score). MRI were classified according to Matsuura's classification (Type 1: abnormal signal type, Type 2: abnormal signal and swelling type, Type 3: cut off end type, Type 4: tapered end type).<BR>The average JOA score increased postoperatively, from 66.8 points to 89.3 points. Regarding the MRI findings, 36 shoulders (92%) out of 39 shoulders of Type 1 remained showing Type 1. 7 shoulders (59%) out of 12 shoulders of Type 2 changed to Type 1, 4 shoulders (33%) remained showing Type 2, and 1 shoulder (8%) changed to Type 3. All 3 shoulders at Type 3 changed to Type 1. 1 shoulder (20%) out of 5 shoulders at Type 4 remained showing Type 4, and 4 shoulders changed to complete rotator cuff tears. The average postoperative JOA score was 90.3 points for Type 1, 95.2 points for Type 2, 86.8 points for Type 3, and 74.6 points for Type 4.<BR>The clinical outcome of ASD for partial rotator cuff tears was mostly satisfactory. The cases of Type 4 changed to complete rotator cuff tears at a high rate, and had a worse result.