腱板断裂に対する鏡視下肩峰下除圧術の術後成績―肩関節拘縮との関連，前向きコホート研究

Arthroscopic Subacromial Decompression for Rotator Cuff Tear. Effect of Shoulder Contracture. A Prospective Cohort Study

　肩関節拘縮を伴った腱板断裂と拘縮のない腱板断裂に対する鏡視下肩峰下除圧術（ASD）の術後成績を比較検討した．腱板断裂に対してASDを行った48例49肩を対象とした．拘縮群に対しては，鏡視下授動術を併用した．術前，術後1カ月，3カ月，6カ月，1年，および2年時に治療成績を評価した．術前に肩関節拘縮を合併していても，鏡視下授動術を併用すれば，術後のJOAスコアの総合評価，機能項目，およびvisual analogue scale（VAS）に影響を及ぼさなかった．また，術後6カ月の時点で拘縮のない腱板断裂症例と同等の可動域が得られた．

　The purpose of this study was to compare and analyze the results of arthroscopic subacromial decompression (ASD) for rotator cuff tear alone and rotator cuff tear complicated by shoulder contracture in 49 shoulders of 48 patients. Arthroscopic release was performed in the contracture group. The results were assessed 1, 3, and 6 months and 1 and 2 years after surgery, and the results in the contracture group and non-contracture group were compared. As long as arthroscopic release was performed to treat preoperative shoulder contracture, no significant differences in total JOA score, function JOA score or visual analog scale (VAS) were seen following ASD for rotator cuff tear. When measured 6 months after surgery, range of motion in the contracture group and the non-contracture group was similar.