アブストラクト
| Title | 腱板断裂の保存治療 - 肩甲上腕関節の内転制限に対する診察と治療 - |
|---|---|
| Subtitle | 第93回日本整形外科学会学術総会 シンポジウム 腱板断裂の保存療法 |
| Authors | 浜田純一郎1, 矢野雄一郎2, 萩原嘉廣3 |
| Authors (kana) | |
| Organization | 1桑野協立病院整形外科・トレーニング部門, 2とちぎメディカルセンターしもつがスポーツ健康科, 3東北大学大学院医学研究科スポーツ・運動機能再建医学寄附講座 |
| Journal | 日本整形外科学会雑誌 |
| Volume | 95 |
| Number | 5 |
| Page | 383-387 |
| Year/Month | 2021 / 5 |
| Article | 報告 |
| Publisher | 日本整形外科学会 |
| Abstract | 「はじめに」腱板断裂は外傷性断裂と非外傷性断裂(変性断裂)に分類され, 前者はスポーツや肉体労働中の外傷により, 後者は加齢変化で発生する. 50歳台から80歳台の100名を調査すると, 非外傷性腱板断裂(atraumatic rotator cuff tear: ARCT)の発生はおおよそ21名であり, そのうち無症候性は14名, 症候性が7名であり, 断裂があっても無症状のことが多い. したがって, ARCTの疼痛, 肩関節の可動域制限・機能低下に断裂自体が関与する頻度は多くはないであろう. ARCTの症状の程度は断裂サイズと関係しない, 理学療法と腱板修復術の成績を比較しても有意差はないなど, 最近この仮説を支持する研究結果が多い. このように症候性ARCTには断裂以外の病態が関与すると推測される. 拘縮がARCTに高頻度で合併し, 断裂以外の病態として拘縮が最も可能性が高い. |
| Practice | 臨床医学：外科系 |
| Keywords | Atraumatic rotator cuff tears, Glenohumeral joint, Adduction restriction, Adduction test, Adduction manipulation |
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参考文献
- 1) Yamamoto A, Takagishi K, Osawa T, et al. Preva-lence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 2010; 19: 116-20.
- 2) Minagawa H, Yamamoto N, Abe H, et al. Preva-lence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. J Orthop 2013; 10: 8-12.
- 3) Tempelhof S, Rupp S, Seil R. Age-related preva-lence of rotator cuff tears in asymptomatic shoul-ders. J Shoulder Elbow Surg 1999; 8: 296-9.
- 4) Dunn WR, Kuhn JE, Sanders R, et al. Symptoms of pain do not correlate with rotator cuff tear severity: a cross-sectional study of 393 patients with a symp-tomatic atraumatic full-thickness rotator cuff tear. J Bone Joint Surg Am 2014; 96: 793-800.
- 5) MOON Shoulder Group, Unruh KP, Kuhn JE, et al. The duration of symptoms does not correlate with rotator cuff tear severity or other patient-related features: a cross-sectional study of patients with a-traumatic, full-thickness rotator cuff tears. J Shoul-der Elbow Surg 2014; 23: 1052-8.
残りの12件を表示する
- 6) Sekiguchi T, Hamada J, Hagiwara Y, et al. Prognos-tic factors for conservative treatment of atraumatic rotator cuff tears. Open Orthop J 2019; 13: 26-31.
- 7) Jost B, Zumstein M, Pfirrmann CW, et al. Long-term outcome after structural failure of rotator cuff repairs. J Bone Joint Surg Am 2006; 88: 472-9.
- 8) Slabaugh MA, Nho SJ, Grumet RC, et al. Does the literature confirm superior clinical results in radio-graphically healed rotator cuffs after rotator cuff repair? Arthroscopy 2010; 26: 393-403.
- 9) Ueda Y, Sugaya H, Takahashi N, et al. Rotator cuff lesions in patients with stiff shoulders: A prospec-tive analysis of 379 shoulders. J Bone Joint Surg Am 2015; 97: 1233-7.
- 10) Yano Y, Hamada J, Hagiwara Y, et al. A new patho-physiology of atraumatic rotator cuff tears: adduc-tion restriction of the glenohumeral joint. JSES Int 2020; 4: 333-40.
- 11) Park JY, Chung SW, Hassan Z, et al. Effect of cap-sular release in the treatment of shoulder stiffness concomitant with rotator cuff repair: diabetes as a predisposing factor associated with treatment out-come. Am J Sports Med 2014; 42: 840-50.
- 12) Tauro JC. Stiffness and rotator cuff tears: inci-dence, arthroscopic findings, and treatment re-sults. Arthroscopy 2006; 22: 581-6.
- 13) Koide M, Hamada J, Hagiwara Y, et al. A thickened coracohumeral ligament and superomedial capsule limit internal rotation of the shoulder joint: Report of three cases. Case Rep Orthop 2016; 2016: 9384974.
- 14) Sasanuma H, Sugimoto H, Iijima Y, et al. Blood flow evaluation by dynamic magnetic resonance imaging of symptomatic rotator cuff tears and fro-zen shoulders. J Shoulder Elbow Surg 2018; 27: e372-9.
- 15) Arai R, Nimura A, Yamaguchi K, et al. The anato-my of the coracohumeral ligament and its relation to the subscapularis muscle. J Shoulder Elbow Surg 2014; 23: 1575-81.
- 16) Jeanfavre M, Husted S, Leff G. Exercise therapy in the non-operative treatment of full-thickness rota-tor cuff tears: A systematic review. Int J Sports Phys Ther 2018; 13: 335-78.
- 17) Endo K, Hamada J, Suzuki K, et al. Does scapular motion regress with aging and is it restricted in pa-tients with idiopathic frozen shoulder? Open Or-thop J 2016; 10: 80-8.
