鏡視下授動術における関節内滑膜所見と術後経過の関連について

概要

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Background: We described clinical evaluation of arthroscopic capsular release for frozen shoulder and consider the indication of this treatment. Methods: Subjects consisted of 20 consecutive patients, including 3 males and 17 females with an average age of 51.2 years old, who were diagnosed as having primary frozen shoulder and had arthroscopic capsular release performed in our institute. The preoperative mean forward flexion and external rotation were 96 and 9.5 degrees respectively. 3 patients of the 20 were affected with diabetes and 2 patients of the 20 had had surgery for breast cancer on the affected side. In all cases, we performed arthroscopic capsular release after conservative treatment for a mean of 7.7 months. 2 patients were combined with ASD. Results: JOA score improved from preoperative 66.5 points to 96.5 points at the final follow-up. Intra-operatively, in patients with abductor muscle weakness and night pain, there was a trend seen in synovial proliferation. Some cases, who had no night pain and decrease of strength in abduction preoperatively, improved immediately ROM. None of the patients had any complications or recurrence of shoulder stiffness. Conclusion: Arthroscopic capsular release was a favorable treatment for refractory frozen shoulder. We recommend surgery for frozen shoulder after improving night pain and strength in abduction, because early improvement of symptoms can be expected.
日本肩関節学会の論文