肩関節
Online ISSN : 1881-6363
Print ISSN : 0910-4461
ISSN-L : 0910-4461
投球障害肩に対する鏡視下手術の効果:再鏡視による検討
柏崎 裕一米田 稔小畠 昌規福島 直宮崎 義雄
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ジャーナル フリー

2001 年 25 巻 3 号 p. 551-555

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[Purpose]The purpose of this study is to evaluate the effects of arthroscopic surgery in throwing athletes with a second look at arthroscdpy.
[Materials and methods]Twenty-eight shouldars which had been operated on from 1993 to 2000 were evaluated. Their average age at the operation was 23 (15-33) years old. There were 25 male and 3 female. The average period from the arthroscopic surgery to second look arthroscopy was 3.9 (3-7)months. There were 25 labral tears which involved 20 type II SLAP lesions. Their additional lesions were 7 articular-sidep artial rotator cuff tears (APRCT),12 inflammatory subacromial bursa (SAB)within 4 subacromial impingement and one bursal-side partial rotator cuff tear (BPRCT). There were 2 Bennett's lesions. One of which was accompanied by APRCT and an inflammatory SAB. There was one APRCT with stretched anterio-inferior glenohumeral ligament (AIGHL). The operative methods were as follows. The labral tear was sutured. The loose middle glenohumeral ligament (MGHL)and/or AIGHL were tensioned with labral repair in 15 cases. APRCT was treated with debridement, and BPRCT underwent arthroscopic repair. Inflammed SAB was treated with bursectomy. Subacromial impingement was treated with arthroscopic subacromial decompression. The stretched AIGHL was shrunken. Then second look labral findings were classified in four grades, complete healing, incomplete healing with granulation, incomplete healing without granulation, and no healing.
[Results]Type II SLAP lesions had complete healing in five cases, incomplete with granulation in six, incomplete without granulation in five and no healing in four. Twelve of fifteen cases of which loose MGHL and/or AIGHL had been tensioned had kept the tension. The previous irregular parts of APRCT were covered with white and smooth membrane in five cases. All of the twelve bursectomy cases had smooth synovial membrane in SAB. All of the four subacromial impingement cases had kept subacrornial space. The cuff was continuing into the greater tuberosity in BPRCT case. Two posterior labral tears in Bennett's lesion were completely healed. The shrunken AIGHL had kept good tension.
[Discussion] 80% of superior labral tears were stabilized repaired with arthroscopic surgery in throwing athletes.100% of SAB lesions had excellent result.

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