鏡視下Bankart修復術前後の二重斜位横断MR関節造影による関節窩陥凹評価と臨床成績の関連

Comparison between Evaluations of the Glenoid Concavity by Double Oblique Axial MR Arthrography and Clinical Results in Arthroscopic Bankart Repair

　スーチャーアンカーを用いた鏡視下Bankart修復術前後の下関節上腕靱帯・関節唇複合体(IGHLLC)の状態を，二重斜位横断像によるMR関節造影(DOA-MRA)で評価した．2004年1月以降に手術を施行した50例57肩を対象とした．術前・術後3カ月・術後6カ月にDOA-MRAを撮影し，IGHLLCの形態をprominent，split，flat，detached，capsular tearに分類し，IGHLLCの傾斜角および関節窩からの高さを測定した．Bankart修復術前後でIGHLLCの傾斜角および高さは有意に増加し，術後6カ月でも維持されていた．術後6カ月のIGHLLCの形態と臨床成績に関連はみられなかった．スーチャーアンカーを用いた鏡視下Bankart修復術による関節窩陥凹の回復は良好であった．

　The purpose of this study was to compare the findings obtained in the glenoid concavity by double oblique axial MR arthrography (DOA-MRA) and the clinical outcome after arthroscopic Bankart repair.　The results in 57 shoulders of 50 patients who underwent arthroscopic Bankart repair were reviewed.　The pre and postoperative lesions in the inferior glenohumeral ligament labrum complex (IGHLLC) were classified into 5 morphological types based on the DOA-MRA findings：prominent (P), split (S), flat (F), detached (D), and capsular tear (C).　The height and slope of the anterior labrum from the glenoid fossa were measured on the DOA-MRA images.　The Japan Shoulder Society Shoulder Instability Score (JSS-SIS) system was used to evaluate the affected shoulder of all of the patients after surgery.　There were no significant differences between the JSS-SISs of the shoulders in the P group, F group, and S＋D group (recurrent Bankart lesion) 6 months postoperatively.　There were significant increases in the slope and height of all of the shoulders as a whole between the preoperative period and 3 months postoperatively, but there were no statistically significant differences in the slope or height between 3 months and 6 months postoperatively.　The initial capsulolabral buttress property was maintained at 6 months after arthroscopic Bankart repair ,and there was no correlation between the morphology of the IGHLLC and the JSS-SISs.