Shishido Hiroaki, Kikuchi Shinichi, Otoshi Kenichi, Konno Shinichi
Department of Orthopedic Surgery, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, Japan.
Fukushima J Med Sci. 2012;58(1):33-9. doi: 10.5387/fms.58.33.
Some patients with rotator cuff tear have shoulder stiffness preoperatively. Concomitant preoperative shoulder stiffness may affect postoperative outcomes of arthroscopic subacromial decompression (ASD) for rotator cuff tear. The purpose of this study was to compare postoperative outcomes for ASD between rotator cuff tear patients with and without preoperative shoulder stiffness and to analyze the serial change in functional scores, range of motion (ROM), and pain intensity of the 2 groups after operation. 60 shoulders of 58 patients who underwent ASD for rotator cuff tear were studied. Arthroscopic release was performed for the stiffness group. The results were assessed before surgery and 1, 3, 6, 12 and 24 months after surgery, and the results in the stiffness group and non-stiffness group were compared. No differences in serial changes for postoperative outcomes of ASD were seen in terms of the Japanese Orthopaedic Association shoulder scoring system (JOA scores) and the visual analog scale (VAS scores) for pain at night and pain during motion between the stiffness group and non-stiffness group. However, compared to the non-stiffness group, forward flexion and abduction angles were significantly smaller for the stiffness group at 1 and 3 months after surgery. External rotation and internal rotation angles were significantly smaller at 1 month after surgery for the stiffness group than for the non-stiffness group. Preoperative shoulder stiffness does not affect improvement of postoperative JOA scores and VAS scores of ASD. When measured 6 months after surgery, ROM in the stiffness group and the non-stiffness group was similar.
一些肩袖撕裂患者术前存在肩部僵硬。术前合并的肩部僵硬可能会影响肩袖撕裂关节镜下肩峰下减压术（ASD）的术后效果。本研究的目的是比较术前有和没有肩部僵硬的肩袖撕裂患者ASD的术后效果，并分析两组术后功能评分、活动范围（ROM）和疼痛强度的系列变化。对58例接受肩袖撕裂ASD手术的患者的60个肩部进行了研究。对僵硬组进行了关节镜松解。在手术前以及术后1、3、6、12和24个月对结果进行评估，并比较僵硬组和非僵硬组的结果。在日本骨科协会肩部评分系统（JOA评分）以及夜间疼痛和活动时疼痛的视觉模拟量表（VAS评分）方面，僵硬组和非僵硬组在ASD术后结果的系列变化上没有差异。然而，与非僵硬组相比，僵硬组在术后1个月和3个月时前屈和外展角度明显更小。僵硬组术后1个月时的外旋和内旋角度比非僵硬组明显更小。术前肩部僵硬不影响ASD术后JOA评分和VAS评分的改善。术后6个月测量时，僵硬组和非僵硬组的ROM相似。
