肩関節多方向不安定症における解剖学的変異:関節鏡下での評価

抄録

The purpose of this syudy was to clarify the arthroscopic findings characteristic of the glenohumeral joint in patients with multidirectional instability of the shoulder (MDI). We compared the arthroscopic findings in a MDI group with those in a control group without instability. The MDI group consisted of 12 patients (9 females and 3 males), While the control group had 10 patients (7 females and 3 males)
The average age of the MDI group was 16.5 years and that of the control group was 17.8years. Arthroscopic assessment was performed in 45°abduction with 3-4 kg of skin traction. The following arthroscopic findings were more common in the MDI group than in the control group; enlargement of the superior recess and rotator interval (83%vs.20%in the control group), ballooning of the dependent pouch (100%vs.50%), a deep gutter under the glenoid fossa (75%vs.0%), hypoplasia of the lower part of the labrum (100%vs.20%), a cord-like and thin middle glenohumeral ligament (MGHL)(93%vs.10%), a lower glenoid attachment site of the anterior inferior glenohumeral ligament (AIGHL) (average3: 30ve.2: 20). However, the superior glenohumeral ligament (SGHL) showed no differences between the two groups. Hill-Sachs lesions of the humeral head (3) and reverse Hill-Sachs lesions (2) were only detected in the MDI group. All of these lesions were small and superficial. In most patients with MDI, capsular enlargement (including rotator interval opening) was observed. In addition, a hypoplastic MGHL, a lower grenoid attachment site of AIGHL, and a hypoplastic labrum were characteristic anatomical variations in MDI.