肩関節拘縮に対して鏡視下関節包解離術を施行した1例における再鏡視下の関節内構造体の変化

概要

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The efficacy of arthroscopic capsular release for patients with frozen shoulder has been reported in several papers. However, we have never found papers which refer to the postoperative change of the intra-articular structures.<BR>We had a patient with severe frozen shoulder treated by circumferential capsular release and had an opportunity of revision surgery to treat residual restriction of external rotation by arthroscopy. In this study, we report the intra-articular findings after arthroscopic capsular release.<BR>In the second look, we found a thick fibrous structure adherent to subscapularis tendon and thought it was the main pathology of the restriction of external rotation. After removing it, we recognized the improvement of external rotation. We also found atrophic capsular ligaments all around the labrum except the antero-superior portion. Especially, a severe atrophy of the anterior band of inferior glenohumeral ligament was observed.<BR>We were concerned about the possibility of dislocation after this surgery and the difficulty of the treatment if that happened. Therefore we should consider the proper indication and the range of the capsular release.