鏡視下安定化手術後に急速な変形性肩関節症の進行をみた高齢者の一例

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Rotator cuff tear is often combined with Bankart lesion in elderly patients with recurrent shoulder instability. Recently, several reports describe the advantage in repairing both Bankart lesion and rotator cuff tear for recurrent shoulder instability in elderly patients. In this article, we report a case of rapid shoulder osteoarthritis after combined arthroscopic Bankart and rotator cuff repair. A 79-year-old female suffered first shoulder dislocation 10 years ago, after that; she dislocated her shoulder 3 times. In December 2008, she visited our hospital complaining about her unstable shoulder. She also complained of pain during shoulder motion and night pain. Imaging study demonstrated Bankart and Hill-Sachs lesion associated with massive rotator cuff tear with joint effusion. We performed arthroscopic rotator cuff repair in addition to Bankart repair. After surgery, she complained of prolonged night and rest pain, and joint effusion. Therefore, we performed joint fluid removal and steroid injection periodically. Four months after surgery, X-ray demonstrated rapid progression of shoulder osteoarthritis associated with joint effusion. Therefore, we performed arthroscopic debridement at 5 months after surgery, after that progression of osteoarthritis and pain subsided gradually. Although massive rotator cuff tear is frequently associated with traumatic shoulder instability in the elderly, rotator cuff repair in addition to Bankart repair may cause rapid progression of osteoarthritis due to high intraarticular pressure after repair. Surgeons should be careful when they treat traumatic shoulder instability associated with both Bankart lesion and chronic massive rotator cuff tear in the elderly.

鏡視下安定化手術後に急速な変形性肩関節症の進行をみた高齢者の一例

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