鏡視下肩峰下除圧術後における単純X線像の経時的変化―前向き研究

Roentgenographic Changes after Arthroscopic Subacromial Decompression : Prospective Study

　抄録：腱板完全断裂に対する鏡視下肩峰下除圧術（ASD）術後の変形性肩関節症と上腕骨頭上方化の経時的変化と自覚症状との関連を明らかにすることを目的とした．術前，術後6カ月，および術後2年に単純X線像を撮影し，変形性肩関節症と上腕骨頭上方化の程度を検討した．さらに，単純X線像の変化と治療成績との関連を検討した．変形性肩関節症の進行は4肩（15％）に，上腕骨頭上方化の進行は3肩（12％）に認められた．ASD術後2年の時点では，変形性肩関節症や上腕骨頭上方化が進行しても，それに伴う治療成績の悪化は認められなかった．

　The purpose of this study was to evaluate the roentgenographic changes after arthroscopic subacromial decompression performed to treat full-thickness rotator cuff tears. The radiographic findings were examined preoperatively, and six months and two years after surgery. Osteoarthritis (OA) of the glenohumeral joint and superior migration of the humeral head observed on the radiographs was classified as grade 0 to grade Ⅲ. The postoperative results were evaluated on the basis of the JOA score and pain assessed by the visual analog pain scale (VAS). Postoperatively, the OA changes had progressed in 4 cases (15％), and the superior migration of the humeral head had progressed in 3 cases (12％). No significant differences in JOA scores or VAS ratings were found between the OA progression group and the no-OA-progression group. The postoperative results did not correlate with OA progression.