肩の鏡視下手術の現況

Present Status in Shoulder Arthroscopic Surgery

　膝関節と同様に，肩関節においても様々な疾患に対して関節鏡視下に手術が可能となってきた．鏡視下手術は一般に，手術瘢痕が小さい，術後の疼痛が軽減される，筋の機能を低下させにくい，復帰が早いなどといった利点をもつが，最も優れている点は，病変に対する正確な手術操作が可能なことである．さらに，少ない侵襲で複数の病変に手術が行える点も有用といえる．しかし，まだ発展途上の段階であり，今後解決すべき問題も多く残されている．本稿では，肩関節においておもに行われている鏡視下手術の最近の知見と現在の問題点，今後の展望について概説した．

Recently, the arthroscopic surgery has been applicable to various pathological conditions of the shoulder as well as knee joint. It has the general advantages of minimal invasion such as small operative scar, decrease in post-operative pain, decrease in loss of muscular function, and early rehabilitation, and most favorable point is the possibility of accurate treatment for lesions. Furthermore, it is possible to treat the overlapping lesions less-invasively. Arthroscopic surgery of the shoulder is still in a “learning curve” and has many problems which must be worked out.