著者

甲斐 義浩 幸田 仁志 山田 悠司 三浦 雄一郎 福島 秀晃 竹島 稔 来田 宣幸 森原 徹

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.43, no.2, pp.411-414, 2019 (Released:2019-09-18)

参考文献数

12

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本研究では,肩関節の総合的な柔軟性を得点化できる肩複合柔軟性テストを考案し,そのテスト法の信頼性と妥当性について検討した.対象は,健常若年者43名,健常高齢者252名,肩病変を有する高齢者111名とした.肩複合柔軟性テストは,外転,内転,外旋,内旋,複合テストの5項目で構成される.各テストには,4段階(0, 1, 2, 3)の判定基準を設定し,5項目の合計得点を0~15点で算出した.分析の結果,本テストの判定一致度(k係数:0.81-1.00)および合計得点(ICC:0.91)ともに,優秀な検者間信頼性が確認された.また,合計得点と肩甲上腕関節可動域との間に有意な正相関が認められた.対象者の合計得点は,健常若年者:12.5 ± 1.7点,健常肩高齢者:10.4 ± 2.5点,病変肩高齢者:8.7 ± 2.8点であり,病変肩群の得点は他の2群と比べて有意に低かった(p < 0.01).これらの知見より,肩関節の総合的な柔軟性を得点化できる尺度として,本法の信頼性と妥当性が示された.

著者

大泉 尚美 末永 直樹 吉岡 千佳 山根 慎太郎 呉屋 五十八

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.43, no.2, pp.619-625, 2019

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近年,ノンセメントステムを用いた人工肩関節置換術ではin-growthステムやショートステムによるradiolucent line (RLL)や骨吸収の減少が期待されている.本研究では,2005-2017年に人工肩関節置換術を施行した105肩を使用機種(スタンダードon-growthステム,スタンダードin-growthステム,ショートin-growthステム)と術式(人工骨頭置換術(HHR),解剖学的全人工肩関節置換術,リバース型全人工肩関節置換術(RSA))別に7群に分類し,術後1年の単純X線にてRLL,ステム先端の骨硬化,spot welds,ステム周囲の骨吸収(Inoue分類Grade 4)を調査した.HHRでは,ショートステムで有意にspot welds出現率が高かった.RSAでは,ショートステムで有意にRLL出現率が低く,spot welds出現率が高かった.骨吸収の出現率は,いずれの術式でも各群間に有意差はなかった.ショートステムでは早期にステム近位の骨のingrowthが得られていた.骨吸収はingrowthステム,ショートステムいずれでも減少は見られず,stress shielding以外の要因が関与している可能性も考えられた.

著者

星野 傑 中川 照彦 佐藤 哲也 八百 陽介 土屋 正光

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.39, no.2, pp.577-579, 2015

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上腕骨骨頭骨折に対し骨釘移植による再接合術が有用であった1例を経験した.オートバイのロードレーサーである20歳男性がレース中に転倒し左肩を受傷,左上腕骨骨頭骨折に対し受傷後8週で肘頭から採取した骨釘および吸収性スクリューを準用し骨接合術施行.術後3年経過し,MRI像にて一部限局した壊死部分を認めるものの骨頭壊死なく骨癒合得られ,痛みなく良好な結果が得られた.

著者

名越 充 橋詰 博行 小西池 泰三 廣岡 孝彦 内田 圭治

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.32, no.3, pp.665-667, 2008 (Released:2008-11-21)

参考文献数

4

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Calcified tendinitis is a common shoulder disease accompanied with severe pain. We experienced many cases of calcified tendinitis over some short periods in a year. We examined the correlation between the occurrence of calcified tendinitis and seasons. 212 patients (males 72, females 140) with acute calcified tendinitis visited to 12 hospitals during two years (January. 2005-December. 2006) in the Chugoku and Shikoku area were investigated. The average age was 57.1 years old. The day of the 1st medical examination and the numbers of cases were examined. The correlation between the occurrence and 4 seasons (March-May, June-August, September-November, December-February) and the correlation in the occurrences between each areas were statistically analyzed. The correlation between the occurrence and seasons was not seen (Wilcoxon signed-rank test). In winter, the mean value of the number of cases of calcified tendonitis tended to be fewest. There was a strong correlation in occurrence between the Sanyo West and Shikoku Setouchi areas (Spearman correlation coefficient ; 0.53997, P=0.0065). More cases and analysis in various points of view are needed for evidence of the correlation between the occurrence and season.

著者

吉松 俊紀 吉松 俊一 斎藤 明義 龍 順之助

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.30, no.3, pp.369-373, 2006-08-18 (Released:2012-11-20)

参考文献数

10

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The aim of this study was to identify the features of isokinetic shoulder and trunk muscle strength of volleyball attackers with shoulder problems and to compare them with those of baseball pitchers.18 competitive high school volleyball attackers and 16 competitive high school baseball pitchers were studied.6 of the attackers and 7 of the pitchers were suffering from shoulder pain but the other players had no history of shoulder pain. The tests were conducted using a Biodex system 3 multi-joint dynamometer. The shoulders were tested for their flexion and extension muscle strength on the scapula plane and trunk muscle strength were tested for their flexion, extension and torso-rotational strengths. The results were compared between the normal group (N-G)and the shoulder injured group (S-G) and also between the attackers and the pitchers. We observed weakness of shoulder flexion strength in S-G of both athletes and the flexion to extension muscle strength ratio was significantly lower in S-G of the attackers. We also noticed the decline of trunk torso rotation to shoulder extension muscle strength ratio in the same group. In comparisons between the attackers and pitchers of N-G, trunk flexion to extension muscle strength ratio of attackers was significantly higher. The reason of the above results, we assumed that the force created from lower extremities was used for jumping in volleyball, while in baseball, it is used for pitching. We also considered that force required for spiking is created from the trunk in volleyball. Characteristics of shoulder muscle strength as dynamic stabilizer are similar in both volleyball and baseball. Appropriate proximal kinetic chain rehabilitation for the leg, hip and trunk should be selected in accordance with the characteristics of sports activities to prevent shoulder injuries. Especially for volleyball attackers, trunk muscle training is a prerequisite to prevent shoulder injuries.

著者

石井 壮郎 宮川 俊平

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.939-943, 2011 (Released:2011-12-21)

参考文献数

12

被引用文献数

1

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There were two purposes for this study. One was to identify risk-factors on dynamics which affected humeral head abnormality on MRI using logistic regression analysis. The other was to simulate stress distribution in humeral head at maximum external rotation (MER) of throwing phase using Finite Element Method analysis (FEM). Then we evaluated the validity of the simulation using MRI findings of humeral head abnormality. The subjects were 18 asymptomatic collegiate baseball players who took part in both MRI and pitching motion analysis. The shoulder joint reaction force was calculated using multi-body dynamics analysis with musculoskeletal model analyzed from foot contact to ball release of pitching motion. We did logistic regression analysis to identify whether the force was a risk-factor or not. As a result, the risk-factor of humeral head abnormality on dynamics was the shoulder joint reaction force (shearing force) at the acceleration phase. We simulated the stress distribution in the humeral head at MER using FEM model and input the shoulder reaction force. Stress distribution in the simulation was almost the same as that of humeral head abnormality in MRI. This simulation is expected to be a useful predictor of the humeral head abnormality caused by internal impingement of throwing shoulder injury.

著者

渡辺 幹彦 藤巻 悦夫

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.367-372, 1999-09-30 (Released:2012-11-20)

参考文献数

6

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The purpose of this study was to clear the clinical results of conservative treatment including the correct pitching form and operative treatments.51 baseball players were studied. Their average age was 22. ly. o. Conserative treatment group including the correct pitching form which in the divided into 7steps and proceeded from the wrist to the foot. Elevating the arm and keeping the scapular plane with the forearm pronated and rotating the trunk on the hip joint were most important. Almost all of the cases had contracture in flexion and adduction of the shoulder.19 cases had problems besides the shoulder and scapula.24 baseball players could play as well as before injury. But players with an injured labrum tear and a partial thickness tear of the rotator cuff could not.10 baseball players had arthoscopic treatment including repair of BLC lesions (Biceps tendon/labrum comlex). Average age was 22 y. o.7 cases had BLC lesions and 8 cases had partial thickness joint side tears. Debridment of the labrum and rotator cuff were performed and repaired BLC lesion with the ROC fastener system in 5 cases.7 cases could play as well as before and all the this cases treatment with repaired BLC recovered completely. Thus we recommend this treatment.

著者

夏 恒治 望月 由 平松 武 柏木 健児 安達 長夫 菊川 和彦 白川 泰山 大前 博路 横矢 晋 奥平 信義

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.28, no.3, pp.453-457, 2004-08-30 (Released:2012-11-20)

参考文献数

14

被引用文献数

1

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CT-osteoabsorptiometry gave us the information about the distribution of mineralization of subchondral bone plate (DMSB). DMSB reflected the stress distribution of joint surface. We analyzed the stress distribution of glenoid cavities in throwing injures of the shoulder by CT-osteoabsorptiometry. Twenty eight patients with throwing injuries of the shoulder,24 patients with other shoulder disorders, and 4 healthy volunteers without any shoulder disorders were evaluated in this study. Group T included 28 affected shoulders of patients with throwing injuries of the shoulder. Group C included 60 non-affected shoulders of all subjects. Three dimensionally reconstructed computed tomograms (3D-CT) and DMSB of the glenoid cavities were filmed before the series of treatment. The glenoid cavity was divided into 7 areas; anterior-superior, anterior, anteriorinferior, posterior-inferior, posterior, posterior-superior and center area. The value of each area was classified into 4 grades. In group C, the mean value of the anterior-superior areas was significantly higher than those of the other areas. Meanwhile in group T, the highest mean value was that of the anterior-superior area. However, the mean values of anterior, posterior, and posterior-inferior areas were significantly higher than those of group C. The form of glenoid cavity in group T evaluated by 3D-CT showed the posterior and posterior-inferior enlargement of the glenoid cavity, which could be interpreted as a Bennett's lesion. Our results supported the hypothesis that a Bennett's lesion would be a reactive bone growth against stress onto the glenoid cavity.

著者

当真 孝 山口 浩 森山 朝裕 金谷 文則

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.42, no.2, pp.526-528, 2018

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我々は広範囲腱板断裂に対し,初期固定力が高く,縫合糸による腱内応力の集中が少ないと報告されているSurface-holding法を用いて手術を行ってきた.今回,一次修復が可能であった術後成績を報告する.対象は広範囲腱板断裂に対して直視下Surface-holding法を用い一次修復術を施行した56例56肩中,1年以上経過観察可能であった50例50肩を対象とした.性別は男性38肩,女性12肩.平均年齢65歳,経過観察期間26カ月.調査項目はJOA スコア,自動屈曲,外旋,内旋(JOA スコアを用いて点数化),Sugaya分類を使用した術後腱板修復状態(type4,5を再断裂)とした.JOAスコアは術前平均57点が術後89点,屈曲は術前平均91&deg;が術後143&deg;,外旋では術前平均39&deg;が52&deg;,内旋は術前平均3.7点が4.9点へ有意差をもって改善を認めた.Sugaya分類typeⅣが3肩,typeⅤが0肩で,再断裂は3肩(6%)であった.Surface-holding法は,再断裂率の低い有用な術式と考えられた.

著者

橋内 智尚 櫻井 悟良 尾崎 二郎 今田 光一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.25, no.3, pp.415-418, 2001-09-05 (Released:2012-11-20)

参考文献数

11

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The purpose of this study is to investigate the pathogenesis and treatment of shoulder pain in hemiplegia.60 shoulders in 60 patients were available and separated into three types on the bases of pain (no or slight, mild, severe). The duration of the hemiplegia, tenderness points, range of motion, manual muscle testing, sensory deficit, edema and the X-ray findings were statistically analyzed. The subacromial bursae of 31 shoulders in 60 patients were injected (A group: 9 shoulders, xylocaine and dexamethazone / B group: 22 shoulders, sodium hyaluronate). Then 4 shoulders were operated on using the one portal arthroscopy. The tenderness points of the C-A arch and around the C-A arch increased with the pain. The improvement rates of pain were 61.7% in A group and 59.1% in B group. A decrease in pain was noted in all of the patients who had been operated on with the one portal arthroscopy. Pain of the shoulder in hemiplegia may be attributable to the C-A arch. Attention to the C-A arch may be of importance.

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

矢野 雄一郎 玉井 和哉 野原 裕 吉崎 邦夫 浜田 純一郎

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.32, no.2, pp.241-244, 2008 (Released:2008-08-30)

参考文献数

6

被引用文献数

1

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To clear whether healthy subjects elevate and lowered their dominant and non dominant shoulder joints in the same manner or not was significantly valuable to understand the pathology of shoulder diseases: rotator cuff tear; impingement syndrome; stiff shoulder; and loose shoulder. 20 young healthy participants (17 males and 3 females, average age 22.6 years old) participated in this study. They randomly elevated and lowered both shoulder joints in the scapular plane at three times and were recorded by 3 dimensional motion analyzer. We calculated the scapulohumeral rhythm in each 10° and analyzed the setting phase. There was statistically no significant difference in the scapulohumeral rhythm between the dominant and non dominant shoulders. Scapulohumeral rhythm was stable (3.5) from 60° in elevation to 50° in lowering, however, individual variation of scapulohumeral rhythm (more than 3.5) was identified except the previous shown angles. To elevate both shoulder joints in the same manner mean that we can compare both shoulders about the scapula motion and arm elevation in patients with shoulder disorders. The setting phase is defined as until 60° in elevation, and moreover, a similar phase as the setting phase with various scapular motion is recognized in the lowering motion.

著者

伊藤 博元 白井 康正 井伊 京一郎 横内 正直 石川 雅人 柴崎 徹 沢泉 卓哉

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.2, pp.195-197, 1986-07-28 (Released:2012-11-20)

参考文献数

7

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Methods of reduction of anterior dislocations of the shoulder have commonly used the Kocher or Hippocratic maneuvers.Many surgeons had prefered the Kocher leverage technique, but recently some authors have not recommended their use because of the possibility of increasing damage to the capsule, soft tissues and injuring the axillary vessels and the brachial plexus. While Milch recommended the forward elevation maneuvers for reduction of anterior dislocations of the shoulder as the simple and safe techniques.Twenty cases were performed with the forward elevation maneuver for the shoulder dislocation in our hospitals. The patients are placed in a supine position on the examining table, intravenous and intramuscular medication are not required. The patients are instructed to relax as much as possible while the maneuver is performed, the arm is very slowly and gently abducted untill 90 degrees.The horizontal adduction on the 90 degrees plane is applied to 90 degrees flextion position, forward flexion is continued untill reduction is carryed out. Nineteen of 20 cases were obtained complete reduction without assistants and anesthesia by this techniques, another one case was needed the muscle relaxant due to severe pain.

著者

吉松 俊紀 福島 一雅 元島 清香 斎藤 明義 龍 順之助 吉松 俊一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.27, no.2, pp.387-390, 2003-08-20 (Released:2012-11-20)

参考文献数

7

被引用文献数

1

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This report showed that the analysis of the isokinetic strength test for throwing shoulder injuries could be used to determine the appropriate time for the patient to return to pitching. During the last six years, among two hundred sixtyfive players studied, one hundred fifty high school baseball players were found to be uninjured while one hundred fifteen players were found to be suffering from throwing shoulder injuries. The tests were carried out using a CybexR II Multi-Joint Dynamometer. The patients were seated with their shoulders abducted at 90 degrees and their elbows flexed at 90degrees. The shoulders were tested for their rotational strength. We observed an imbalance of isokinetic strength of the shoulder by noticing a difference between the internal and external rotational strengths. In addition, we examined the data of concentric isokinetic endurance strength that had not been reported previously. Returning to pitching was found to be highly possible when the patients corrected the imbalance of internal and external rotational strengths and their concentric isokinetic endurance strength was above 70% measured by the concentric endurance strength test. Correction of the imbalance of internal and external rotational strengths and the improvement of endurance strength were considered to be necessary to judge the appropriate time for returning to pitching.

著者

井手 淳二 山鹿 眞紀夫 北村 歳男 田上 学 前田 智 高木 克公 森澤 佳三

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.2, pp.311-314, 1997-06-25 (Released:2012-11-20)

参考文献数

7

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(Purpose)We Studied the diagnosis and surgical management of suprascapular nerve entrapment neuropathy in athletes.(Materials and methods)Eighteen patients with infraspinatus muscle atrophy were studied. Fourteen were men and 4 women. Their mean age was 27 (range 14 to 40) years. The diagnosis was confirmed by physical and electromyographic examinations. As an ancillary test, MRIs of the shoulder joint were obtained. Those patients with rotator cuff tear were excluded from this study.(Results)Electromyographic examinations showed an abnormality in 8 patients. Two of them had isolated paralysis of the infraspinatus muscle. We operated on 4 patients with suprascapular nerve entrapment. We performed a release of the superior scapular transverse ligament on 2 patients with paralysis of the supraspinatus and infraspinatus muscles, a shaving of the spinoglenoid notch on a patient with isolated paralysis of the infraspinatus muscle and removed the ganglion cyst in 1. All the patients had good results, however, they needed 1 or 2 years to recover from paralysis.(Conclusion)Early diagnosis and treatment are important for the management of suprascapular nerve entrapment neuropathy in athletes.

著者

岩堀 裕介 佐藤 啓二 花村 浩克

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.24, no.3, pp.377-381, 2000-09-30 (Released:2012-11-20)

参考文献数

7

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The effect of the throwing form correction for a baseball shoulder was evaluated. Materials and methods: Forty-five baseball pitchers with throwing pain in their shoulders were examined. All were males aged 10 to 31 years (mean 17.4), with a duration of shoulder pain on throwing of 32 months in average (range 2 weeks to 11 years). The throwing motions were recorded by a digital video camera and were evaluated as to whether there were any problems in the throwing form. The throwing form was corrected and grade of pain relief and return to pitching was inquired into. Results: Forty-two of the 45 cases (93%) had one or more problems in their throwing form. Problems in the throwing arm in 35 cases (83%), in the trunk or lower extremities motion in 32 cases (76%) and in the opposite arm in 23 cases (55%) were observed.Remarkable or moderate pain relief in 28 cases (67%) and complete return to pitching in 21 cases (50%) were gained by throwing form correction. The outcomes were better in the younger cases and the cases with the shorter periods form the onset of the pain. Conclusion: The throwing form correction was effective for baseball shoulder, especially for the younger cases.

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

尾崎 二郎 仲川 喜之 増原 建二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.12, no.2, pp.211-213, 1988-08-10 (Released:2012-11-20)

参考文献数

6

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Twelve cases with isolated tear of the subscapularis tendon were observed during 250reconstructive procedures on the rotator cuff. The patients' age was 51.6 years on average. All of the patients had a definite history of trauma to an affected shoulder and persistent pain in the anterior shoulder part, combined with the inability to evevate the extremity. Arthrography was performed on all, and revealed that the dye had extravasated into the subacromial bursa, however, the supraspinatus tendon was intact on the external rotation view. Operative findings revealed that an isolated rupture of the subscapularis tendon was confirmed in all. In 10 cases with rupture of the supero-medial part of the subscapularis tendon, medial dislocation of the bicipital long tendon was observed. Therefore, the authors conclude that the supero-medial part of the subscapularis tendon, including the medial bundle of the coracohumeral ligament, is the most important portion which keeps the bicipital long tendon aligned with the sulcus, and that during reconstructive procedures on the shoulder capsule, these changes should be carefully looked for and evaluated.

著者

下川 寛一 伊藤 仁

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.30, no.2, pp.281-284, 2006-06-30 (Released:2012-11-20)

参考文献数

15

被引用文献数

1 14

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The purpose of this study was to clarify the clinical outcomes and problems of arthroscopic rotator cuff repair (ARCR) in patients 65-years of age and older. We evaluated the clinical results and repair integrity using MRI in 42 patients with ARCR (18 men and 24 women, mean age at the time of surgery 70.3 years old). Preoperatively and at the time of follow-up (at a mean of 19.1 months), the patients were assessed with Japanese Orthopaedic Association (JOA) shoulder scores. Subjective symptoms and JOA shoulder scores of all patients improved after surgery (p<0.0001). The average postoperative JOA shoulder score at 12 months after surgery improved to 96.5 (vs.51.5 preoperatively) points. An average postoperative abduction range improved to 170°(preoperatively 94° ), and external rotation improved to 61° (preoperatively 20° ). Postoperative complications including CRPS, shoulder stiffness and anchor failure were not seen in this series. No differences were observed in clinical outcomes compared with 24 shoulders in patients 65-years of age and younger. MRI examinations 6months postoperatively showed high intensity in the repaired cuff in 9 of 18 shoulders that had had large and massive tears, whereas small and medium tears presented good repair integrity in 88% (21 of 24 shoulders).

著者

橋口 宏 江川 慶長 伊藤 博元

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.30, no.3, pp.485-488, 2006-08-18 (Released:2012-11-20)

参考文献数

5

被引用文献数

3

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The purpose of this study was to analyze factors that influence the outcome of nonsurgical treatment for partial-thickness rotator cuff tears (PTRCTs). Sixty-one patients with PTRCT included 34 women and 27 men with a mean age of 55.7 years old were evaluated.43 patients had a history of trauma such as a fall or traffic accident. The types of PTRCT were revealed by MRI. A bursal-sided tear of the cuff was observed in 32patients, a joint-sided tear in 20 and an intratendinous tear in 9. All the patients were treated nonsurgically for a mean duration of 5.7 months. Satisfactory results were achieved in 28 patients.33 patients with unsatisfactory results eventually required surgery. Factors of the 33 nonresponsive patients to the 28 responsive patients to treatment were compared. The factors were as follows; characteristics of the patients, range and strength of the shoulder motion, and radiographic factors, such as size of the subacromial spur and acromial morphology. All data were statistically evaluated using a logistic analysis. The significance level was set at P < 0.05, and odds ratios were figured. Identified factors that had a significant difference between the two groups were age, size of the subacromial spur, bursal side tear, and range of forward elevation (FE) and external rotation (ER). Positive correlation was demonstrated in age and range of the motions, and negative correlation in size of the spur. Each ratio of age, size of the spur, bursal. side tear, FE and ER was 3.33, 2.55, 33.33, 1.1 and 1.11respectively. This study suggested that the younger the age, a bursal-sided tear, a large subacromial spur and motion restriction of the shoulder are factors that induce a poor outcome of nonsurgical treatment for PTRCTs.