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―第2報 MRIによる前向き検討

Changes in the Size of Rotator Cuff Tear after Arthroscopic Subacromial Decompression. : Part 2 : Evaluation with MRI

　腱板完全断裂に対する鏡視下肩峰下除圧術（ASD）の術後における腱板長軸方向と短軸方向における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年にMRIを撮像した．さらに，MRI撮像時における治療成績を調査した．ASD術後2年において，腱板の長軸方向で7肩（27％），短軸方向で6肩（23％）に断裂の拡大が認められた．断裂拡大による疼痛や可動域の悪化は認められなかった．しかし，腱板短軸方向の断裂が拡大している症例では，JOAスコアの機能項目は低下していた．

　Relationships between changes in the length and width of rotator cuff tears and symptoms after arthroscopic subacromial decompression (ASD) were investigated in a prospective study. MRI was performed before the operation and again 6 months and 2 years after the operation, and changes in the size of the rotator cuff tears were analyzed. At 2 years after ASD an increase in the length of the rotator cuff defect was seen in 7 shoulders (27％), and increase in width in 6 shoulders (23％). No worsening of pain or ROM accompanying the enlargement of the rotator cuff tears was seen. However, the increase in width of the rotator cuff tears resulted in a poorer JOA score for function.