反復性肩関節前方脱臼に対する鏡視下Bankart修復術の治療成績-Prospective study-

抄録

The purpose of this study was to evaluate the results of Caspari's method using non-absorbable sutures and buttons for a recurrent anterior dislocation of the shoulder.54 shoulders in 54 patients who underwent Caspari's method were studied. The average age at operation was 25 years old. The postoperative clinical results were evaluated by JSS Shoulder Instability Score and Rowe's score. Moreover, the amount of bone defect in the glenoid at the 4 o'clock position and Hill-Sachs' lesion was measured using MRA, and the correlation between the amount of bone defect and redislocation rate were investigated. The mean JSS scores were 49.3 points before the operation and 92.3 at two years after the operation, indicating a significant improvement Rowe's scores were excellent for 40 patients, good for 10 patients and poor for 4 patients. A redislocation occurred in 4 patients. Bone defects in the glenoid were found in 16 patients(37%). The amounts of bone defects in the glenoid were less than one-quarter of the anteroposterior diameter of the glenoid (small bone defect) in 14 patients and one-quarter or more (large bone defect) in 2 patients. Redislocation occurred in 2 shoulders (100%) with a large bone defect The Caspari technique might not be effective for cases in which the amount of bone defect in the glenoid is one-quarter or more of the anteroposterior diameter of the glenoid.