鏡視下肩峰下除圧術後における腱板断裂の経時的な変化―MRIによる検討

Changes in the Size of Rotator Cuff Tears after Arthroscopic Subacromial Decompression : Prospective Study by MRI

　抄録：腱板完全断裂に対する鏡視下肩峰下除圧術（ASD）術後の腱板断裂の大きさの経時的変化と症状との関連を検討した．術前，術後6カ月，および術後2年でMRIを撮像した．さらに，MRI撮像時における日整会肩関節疾患治療成績判定基準（JOAスコア）とvisual analog pain scale（VAS）を調査した．術後6カ月から術後2年で，断裂の拡大が認められた症例は7肩，32％であった．JOAスコアとVASには断裂不変群と断裂拡大群との間に有意差は認められなかった．ASD術後2年においては，断裂拡大に伴う治療成績の悪化は認められなかった．

　The relationships between changes in the size of rotator cuff tears and symptoms after arthroscopic subacromial decompression (ASD) were investigated. MRI was performed before the operation and at 6 months and 2 years after the operation, and changes in the size of the rotator cuff tear were analyzed. Correlations between changes in size of rotator cuff tears and treatment results, i.e., JOA score and visual analog pain scale (VAS) score, at 6 months and 2 years after the operation were also investigated. An increase in the size of the rotator cuff tear during the period from 6 months to 2 years after the operation was seen in 7 (32％) of the shoulders (enlarged group). There were no significant differences in either the JOA scores or the VAS scores between the unchanged group and enlarged group. No deterioration in treatment results accompanying cuff tear enlargement was seen at 2 years after ASD for rotator cuff tear.