投球側の反復性肩関節前方不安定症に対する鏡視下手術の治療成績

抄録

PURPOSE: The purpose of this study was to reveal the outcome after arthroscopic stabilization for recurrent traumatic anterior instability occurred in the throwers' dominant arm.
METHOD: Arthroscopic stabilization for thrower's dominant shoulder has been performed under the following principles: adequate IGHL tensioning using suture anchors loaded with high strength sutures, which is accomplished by mobilization of labroligamentous complex from 2:00 to 7:30 associated with cartilage resection with 2 to 5mm width at the edge of the glenoid surface from 3:00 to 7:30; repair of associated pathology including capsular and labrum lesions. Since January. 2004 through April. 2006, 31 overhead athletes underwent the index surgery for their dominant arm.
7 patients were interviewed by telephone and the rest of 24 patients were examined at our office, which was 31.8 months (range, 24 to 48) after the index surgery on average.
RESULTS: The average Rowe, UCLA, and JSS Sports scores improved significantly respectively. 20 (80%) had returned to their sports at the preinjury level, 3 (12.5%) to their sports with minimal restriction, and 6 had quit their sports for some specific reasons rather than the shoulder. 2 patients (6.5%) experienced redislocation. Every single patient, who could not return to their sports at their preinjury level, had evident functional problems including scapula or trunk.
CONCLUSION: Arthroscopic stabilization with emphasis of IGHL tensioning for throwers' dominant arm worked very well. However, to achieve complete return to their sports, athletic rehabilitation in order to obtain proper throwing mechanics is necessary.