著者

岡村健司

出版者

財務省

雑誌

フィナンシャル・レビュー

巻号頁・発行日

no.43, 1997-11

著者

廣瀬 聰明 野中 伸介 上野 栄和 木村 重治 吉本 正太 道家 孝幸 杉 憲 岡村 健司

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.883-887, 2011 (Released:2011-12-21)

参考文献数

12

被引用文献数

4

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We performed arthroscopic rotator cuff repair (ARCR) for all rotator cuff tears. The purpose of this study was to evaluate the clinical results of ARCR using double-row technique. We retrospectively studied 64 patients (65 shoulders) who had received ARCR using double-row technique and who were followed up for more than 2 years. The patients were 30 males and 35 females. The mean age at operation was 65 years old (range, 44-86). The mean postoperative follow-up period was 25 months (range, 24-36). The clinical results were assessed using JOA scores and MRI by Sugaya's classification. Tear size was small tear in 9 shoulders, medium in 36, large in 12, and massive in 8. The mean JOA total score was significantly improved from 66 points preoperatively to 96 points postoperatively. Postoperative MRIs showed 20% re-torn cuff in all cases, especially, 40% in large and massive tears. In 45 shoulders which had MRI taken regularly, re-tear by MRI was revealed within 3weeks: none, at 3 months: 4 shoulders, at 6 months: 1shoulder, at 1 year: 4 shoulders, and 2 years: none. In this study, the clinical results of ARCR using double-row technique was mostly satisfactory. But JOA score in no tear group (97points) was better than re-tear group (92points). So we have to consider the methods to prevent re-tear after ARCR.

著者

岡村 健司 木村 明彦 福島 直 青木 光広 薄井 正道 石井 清一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.23, no.3, pp.453-456, 1999-09-30 (Released:2012-11-20)

参考文献数

7

被引用文献数

7

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[Purpose] Recurrent anterior dislocation of the shoulder in elderly patients has seldom been reported, and the pathologic features of this group have not been fully clarified in the literature. The purpose of this study was to report our operative findings and to investigate the etiology of the recurrent anterior dislocation of the shoulder with onset after the age of 50.[Materials and Methods] We retrospectively studied nine patients who were over 50 years old at the time of initial traumatic dislocation and then who had recurrent instability of the shoulder. We evaluated the operative findings as follows: rotator cuff tear, Bankart lesion, anterior capsular injury. One patient was treated with the Putti-platt method and three had inferior capsular shifts. The other five patients were treated with a Bankart repair. In addition to those operations, seven of them were treated with a modified Bristow method.[Results] Rotator cuff tears were seen in 5 patients, and four of them were massive tears with a subscapularis rupture. There was an elongation of the subscapularis in the other patient. Bankart lesions were seen in 5 patients with a bony lesion. The other 4 patients had abnormal lesions of the anterior capsule.[Conclu sion] In elderly patients, destruction of the shoulder anterior stability structure including the sabscapularis should be considered as one of the main causes of recurrent anterior dislocations.

著者

林田 賢治 米田 稔 岡村 健司 広岡 淳 脇谷 滋之 妻木 範行

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.17, no.2, pp.315-319, 1993-09-01 (Released:2012-11-20)

参考文献数

8

被引用文献数

1

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To decide the appropriate treatment for articular-side partial rotator cuff tears (APRCT),31patients with arthroscopically documented APRCT were surgically treated and reviewed retrospectively. The mean age at time of operation was 31 years old (13-62) and the mean post-operative follow-up period was 22.5 months (12-66). APRCT was classified into three groups according to the depth of the cuff tear, the superficial tear (S-tear), the intermediate tear (I-tear), and the deep tear (D-tear).8 patients with a S-tear were treated by arthroscopic debridement of the lesion (S-tear &debridement group).23 patients had an I-tear.16 of them had an arthroscopic debridement of the lesion (I-tear & debridement group) performed of time, and 7 of them were treated by open repair procedure (I-tear & repair group).3 patients with a D-tear were treated by open repair procedure (D-tear & repair group). Arthroscopic or open subacromial decompression were simulteneously performed in all of the cases. The functional results were graded by Constant's shoulder rating scale (1987) which consisted of the evaluation of pain, function, range of motion, and strength of abduction. Clinical results were evaluated by the ratio of the rating scale; the involved side / the healthy side (%). Statistic significances were calculated by Student's t-test.According to the ratio of total clinical evaluation, the S-tear & debridement group was 99.3 +2.9%, the I-tear & debridement group was 97.4 + 4.4%, the I-tear & repair group was 87.3 + 7.7%, and the D-tear & repair group was 87.5 + 14.0%. There were no significant differences between the S-tear & debridement group to 2 and the I-tear & repair group to 4, but there was a significant difference between the I-tear & debridement group to the I-tear & repair group (p <0.01). The results of the strength of abduction were the S-tear & debridement group was 93.6 + 11.4%, the I-tear & debridement group was 98.4 + 18.7%, the I-tear & repair group was 78.6 + 11.2%, and the D-tear & repair group was 97.6 + 4.1%. A significant difference was also seen between the I-tear &debridement group to the I-tear & repair group (p <0.01).In this follow-up study, two things were clarified. Firstly, the clinical outcome of an arthroscopic debridement for APRCT was not influenced by the depth of a lesion with less than half of a rotator cuff thickness. Secondly, the arthroscopic debridement for an intermediate type APRCT with subacromial decompression provided a more favorable clinical outcome than did the open repair technique.

著者

今井 智仁 尼子 雅敏 津田 悦史 杉本 憲一 岡村 健司 瀧内 敏朗

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.27, no.3, pp.545-548, 2003-10-30 (Released:2012-11-20)

参考文献数

10

被引用文献数

2

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We sought to evaluate our current method of surgical treatment of the recurrent anterior dislocation and subluxation in JSDF personnel. Twenty-three shoulders in twenty-one personnel were evaluated. All were males with an average age of twenty four point seven years old (range nineteen to thirty-three) at the time of surgery. The average time of follow-up was four years and one month (range two to six years and four months). The evaluations of clinical results were by: 1. Rowe' s shoulder score,2. Range of motion,3. Re-dislocation ratio,4. Satisfaction rating,5. Return to pre-morbid activities,6. Complications.Twenty-two of twenty-three shoulders had good to excellent results when rated by the Rowe's scoring method. Redislocation ratio was 0 %, re-subluxation ratio was 4%. The average range of motion was diminished to seven degrees when compared to the normal unaffected side. Almost all of the twenty-one patients were satisfied with the treatment. Four failed to return to their pre-injury activities because two feared a re-dislocation and two were not in their pre-injury circumstances. The physical demands of the JSDF pesonnel are strenuous and demanding. JSDF personnel with dislocated shoulder require careful and precise repair to stabilize the shoulder to return as soon as possible to the force and as many as their pre-injury activities. The symptoms of recurrent dislocation or subluxation were enough to keep some individuals from returning to their full pre-injury functions. Confidence and stability are the keys to successful repair and return. If these findings are not there, JSDF personnel must be directed into less strenuous activities.

著者

今井 智仁 尼子 雅敏 津田 悦史 杉本 憲一 岡村 健司 瀧内 敏朗

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.27, no.3, pp.545-548, 2003-05-01

被引用文献数

2