肩鎖関節変形性関節症に対する鏡視下鎖骨遠位端切除術の中期臨床成績

抄録

Background: The purpose of this study was to evaluate medium term clinical results of arthroscopic distal clavicle resection for the treatment of painful acromioclavicular (AC) joint osteoarthritis.
Methods: We evaluated 101 shoulders of 91 patients, who had undergone arthroscopic distal clavicle resection with a minimum 12 months follow up. Average age at the time of surgery was 59.1 years old and average duration of the follow up was 40.6 months. Histories of traumatic episode were observed in 3 cases of type I and II AC joint injury and in 8 cases of other major traumatic events. Clinical evaluation was composed of 4 different items: other pathological lesions except AC lesion, arthroscopic surgical procedure, tenderness of the AC joint and horizontal adduction test.
Results: Impingement syndrome was accompanied in all the cases. Thirty-eight cases of SLAP lesion, 52 cases of rotator cuff tears, 17 cases of LHB tear and 30 cases of shoulder joint stiffness were observed. ASD and arthroscopic distal clavicle resection was performed on 101 shoulders, ARCR on 28 shoulders and capsulotomy on 30 shoulders. Complete disappearance of AC joint tenderness was recognized in 94 shoulders; mild AC joint tenderness remained in 7 shoulders at final follow up. There was no pain in horizontal adduction test in all cases at final follow up as well as at 3 months follow up.
Conclusion: Our results showed arthroscopic distal clavicle resection is an effective surgical procedure at medium term follow up for the treatment of painful AC joint osteoarthritis.