著者

浜田 純一郎 高瀬 勝巳 藤井 康成 乾 浩明 小林 勉 後藤 昌史 塩崎 浩之 畑 幸彦 田中 栄 林田 賢治 森澤 豊 森原 徹 山本 宣幸

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.45, no.1, pp.122-126, 2021 (Released:2021-08-30)

参考文献数

9

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凍結肩について,AAOSの定義と分類やISAKOSの提言があり混乱がある.そこで会員に対し凍結肩のアンケート調査をおこなった.その結果,AAOSの一次性凍結肩の定義,一次性・二次性凍結肩の分類に同意する会員はそれぞれ63%,53%であった.原因不明の拘縮肩の診断名は凍結肩31%,拘縮肩22%,肩関節周囲炎16%,五十肩16%と多くの病名が使われていた.調査結果から凍結肩と拘縮肩の定義の曖昧さとAAOSの定義や分類への同意率が低いことがわかった.英語論文100編を調査するとadhesive capsulitisが45%,frozen shoulderが41%であり欧米ではこの2病名を主に使っていた.拘縮肩と凍結肩の定義を明確化するため学術委員会では,可動域制限があれば拘縮肩とし,そのうち原因不明な拘縮肩のみを凍結肩,原因の明らかな拘縮肩を二次性拘縮肩とするISAKOSの提言を採用した.

著者

林田 賢治 田中 誠人 小泉 宏太

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.853-856, 2011 (Released:2011-12-21)

参考文献数

4

被引用文献数

1

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The clinical result of arthroscopic triple row suture anchor repair (combined operation of double anchor footprint fixation and single row method) for complete rotator cuff tear is reported in the present study. Twenty-two shoulders (the average age at operation was 69 years old: range 53-78) were involved and followed for more than 6 months (average follow up: 10 months). The clinical results were evaluated with JOA shoulder score and post operative cuff integrity was assessed by MRI and classified with Sugaya's classification. The pre-operative average JOA score, which was 71.5, improved to 92.1 at follow up. Regarding post operative cuff integrity, complete repair (type 1 and 2) was seen in 13 shoulders (59%), repaired with thin tendon (type 3) was seen in 2 shoulders (9%), re-tear (type 4 and 5) was seen in 7 shoulders (32%). In re-tear cases, 6 of 7 were type 4, and type 5 was seen in only 1 case. Comparing this to our previous data of repair integrity of double row suture anchor method, type 4 increased and type 5 decreased. Cutting out tendon by tight bridging sutures could be the cause of increasing type 4, and tension adjustment of bridging sutures could be important to prevent tendon cut out.

著者

林田 賢治 中川 滋人

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.29, no.2, pp.427-430, 2005-06-30 (Released:2012-11-20)

参考文献数

6

被引用文献数

1

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The aim of this study was to elucidate the relation between ball speed in pitching during a baseball game and the power of external rotation (ER) of the shoulders. Nineteen games, which were at the national inter high school baseball tournament games in Japan, in which the pitchers threw more than 100 times, and the ER strength before the tournament and after the games were measured, were included in the present study. The straight balls were decided by the ball speed data and video tapes of the games and a mean straight ball speed in the first 30 pitches and the last 30 were calculated. The relation between the changes of ball speed and ER strength were assessed. In 8 of 19 games, the ball speed decreased more than 3 km/h between the first 30pitches and the last 30 pitches and these games were classified into speed decreased game (DG), and the other 11 games were into non DG. The mean ratios of ER strength of the throwing side to the non throwing side were 1.02 in non DG and 0.99 in DG before the tournament. The mean ratios of ER power were 1.02 in non DG and 0.95 in DG after the games. The differences of ER ratios between before the tournament and after the game were +0.012 in non DG and -0.041 in DG, and a statistical significant difference was recognized between them. A decrease of straight ball speed during a game relates to a decrease of ER strength ratio. Maintaining ER strength could be one of the ways to keep ball speed in the game.

著者

中川 滋人 林田 賢治 米田 稔 山本 隆文

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.21, no.3, pp.413-417, 1997-08-31 (Released:2012-11-20)

参考文献数

13

被引用文献数

2

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The purpose of this study was to clarify the mechanism of rotator cuff tears seen in baseball players.Forty baseball players who injured their shoulders through repetitive throwing and underwent shoulder arthroscopy were studied retrospectively using a videotaped arthroscopic tour. They ranged in age from 13 to 48 years (average: 24 years) and were classified into 3 groups according to the rotator cuff findings: articular-side partial rotator cuff tear (APRCT)in Group 1 (29 patients), cuff inflammation only in Group 2 (5 patients), and intact cuff in Group 3 (6 patients). The existence and the site of rotator cuff tears, labral tears and notches of the greater tuberosity were examined in each group.All APRCTs were located around the posterior aspect of the supraspinatus tendon (SSP) and the anterior aspect of the infraspinatus tendon (ISP). Localized splits of the posterior rotator interval were recognized in 5 patients. In most of the other patients in Group 1, the deepest APRCT was also located in the posterior rotator interval. Posterior-superior labral fraying was seen in 22 patients (17/29 in Group 1,0/5 in Group 2, and 5/6 in Group 3). However, posterior labral lesions localized to the superior portion were only recognized in 4 patients in Group 1 and SLAP lesions were combined with this posterior lesion in 5 patients. The remaining 8 patients in Group 1 had labral fraying of the whole posterior portion. A notch of the greater tuberosity around the insertion of the ISP was recognized in 23 players, which showed it had a significant relationship to cuff lesions (21/29 in Group 1,2/5 in Group 2, and 0/6 in Group3).The most significant APRCTs were located around the posterior rotator interval between the SSP and ISP. APRCTs caused by repetitive throwing activity may be initiated by tearing between the SSP and ISP due to an eccentric or shearing force. They were not always associated with posterior-superior labral lesions as predicted by the internal impingement theory.

著者

林田 賢治 中川 滋人

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.29, no.3, pp.651-654, 2005-08-10 (Released:2012-11-20)

参考文献数

9

被引用文献数

4

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The aim of this study was to elucidate the relationbetween internal (IR) and external rotations (ER) strength of the shoulder and shoulder pain during throwing in high school baseball pitchers. Internal and external rotation strength of the shoulder were measured in 401 high school pitchers, who had attended the national inter high school baseball tournament in Japan, and the influence of internal and external rotation strength of shoulder on shoulder pain during the throwing were assessed. The average IR and ER strength were 105.3+/-32.2N and 93.1+/-28.3N. The average IR. ER, and ER/IR ratio were 1.18+/-0.22,0.98+/-0.14, and 0.92+/-027, respectively, in all pitchers. All pitchers were classified into two groups. The pain experienced group (P group), which involved the pitchers who had experienced shoulder pain during throwing prolonged more than one month within the year, included 40 pitchers, and the other group (NP group) included 361 pitchers. The IR, ER, IR ratio, ER ratio, and ER/IR ratio were compared between both groups. The ER/IR ratio of the P group was lower than that of the NP group, with a statisticaldifference by unpaired student t-test (p=0.02). Pitchers with a low ER/IR ratio tend to injure their throwing shoulder and proper ER/IR ratio could be one of important condition for throwing shoulders.

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.