肩関節多方向性不安定症に対する関節鏡視下関節包縫縮術の短期臨床成績

抄録

Arthroscopic capsular plication has been reported to be a novel surgical treatment for MDI: Multidirectional instability of the shoulder, which was previously treated by capsular shift open surgical procedure. The purpose of this study was to evaluate short term clinical results of arthroscopic capsular placation for MDI. We retrospectively evaluated 17 shoulders (16 patients, 15 male and 1 female) arthroscopically treated by capsular plication. Arthroscopic capsular plication was performed for the loose capsular portion which was correctly determined by symptom and physical examination under anesthesia.The average age at the time of surgery was 28.17 years old(range, 15-47 years). The average follow-up was 26.0 months (range, 6-60 months). Clinical results were evaluated by symptomatic instability, physical examination and assessment with JSS shoulder instability score. Disappearance of instability by physical examination with no apparent complication was confirmed in all cases and surgical good effect of this procedure was recognized. However we observed symptomatic instability remained in 7 of 17 shoulders (41.2%) and patients' symptom has not yet completely disappeared. The average JSS shoulder instability score improved from 52.4 points preoperatively to 91.4 points postoperatively. Patients treated with Arthroscopic capsular placation for MDI have shown excellent short term clinical outcomes. Longer follow up is necessary for the evaluation of the remaining symptomatic instability.