Arthroscopic Subacromial Decompression for Impingement Syndrome by E. Shimozaki, K. Kitaoka, T. Matsumoto, H. Itokawa, T. Kobayashi and K. Tomita Depa

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1 Arthroscopic Subacromial Decompression for Impingement Syndrome by E. Shimozaki, K. Kitaoka, T. Matsumoto, H. Itokawa, T. Kobayashi and K. Tomita Department of Orthopaedic Surgery, School of Medicine, Kanazawa University Arthroscopic subacromial decompression has been performed for shoulder impingement syndrome since Ellman reported an overall success rate of 88%. the results of arthroscopic subacromial decompression our hospital. ASD was performed on 16 patients (18 shoulders). from 19 to 60 years (mean : 39 years). The purpose of this paper is to assess (ASD) for shoulder impingement syndrome in The age of the 12 men and 4 women ranged 13 shoulders were classified as stage II and 5 shoulders as stage III (1 full thickness rotator cuff tear and 4 partial rotator cuff tears). The follow-up period ranged from 6 to 36 months (mean : 21 months). The results were evaluated on the JOA shoulder rating score. The average JOA score improved from 77.1 to 96.3 points. There was a significant improvement in pain, and 15 shoulders (83.3%) had satisfactory pain relief. With respect to complications, there were no infections or nerve palsy, but a fracture of the acromion occured 2 weeks after the operation in one patient. Furthermore, one patient with a full-thickness rotator cuff tear was reoperated on a cuff repair. pain. Three athletes in this series returned to their previous sports' level ability without any ASD allows for a less scarring procedure with fewer complications and a thorough diagnostic evaluation of the glenohumeral joint and rotator cuff. Since the deltoid muscle is not detached, patients can resume their daily routines immediately. In reviewing our results, ASD is recommended as an alternative to open anterior acromioplasty in advanced impingement syndrome cases. key words : arthroscopy subacromial decompression shoulder joint

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3 TheShoulderJoint,Vol.17,No.2, ,1993. もな く水 泳 ク ラ ブに通 って い る(図2-a,b,c). 代 表 症 例 症 例 は60歳 の男 性 で あ る.肩 関 節 造 影 で完 全腱 板 断 症 例 は48歳 の女 性 で,市 の 水泳 ク ラブ に所 属 して い 裂 を認 めた が疹 痛 が 主体 で 自動挙 上 には問 題 が な か っ る.右 肩 挙 上 時痛 を訴 え,約 半年 間 の保 存 的 治療 で軽 た の で,ASDを 快 しな い た めASDを の の不 満 を訴 え るた め,半 年 後 に腱 板 修復 術 を行 っ た 行 っ た.術 前 肩 峰前 方 の骨 棘 と 腱 板 不全 断 裂 を認 めて いた,腱 板 不 全 断裂 に対 して は 特 に処置 は しなか った が,術 後2年5カ 行 っ た.術 後 は幾 分 除 痛 が得 られ た も (図3-a,b,c). 月の 現在 疹 痛 図3.症 例60歳,男 性 (a)術 前X線(矢 印:骨 (b)関 節 造 影:完 全 腱 板 断 裂 を認 め る (c)術 後X線:肩 峰 の 切 除 は十 分 で あ る 一230一 棘)

4 1) Ellman, H.: Arthroscopic subacromial decompression. Orthop. Trans., 9 : 48, ) Ellman, H.: Arthroscopic acromioplasty.: McGinty, J. B.(ed), Operative Arthroscopy. Raven Press, New York, , ) Esch, J. C. et al.: Arthroscopic subacromial decompression : Results according to the degree of rotator cuff tear. Arthroscopy, 4 : , ) Neer, C. S.: Anterior acromioplasty for the chronic impingement syndrome in the shoulder, J. Bone and Joint Surg., 54-A : 41-50, ) Sampson,T.G. et al.: Precision acromioplasty in arthroscopic subacromial decompression of the shoulder. Arthroscopy, 7: , ) Speer, K. P. et al.: Arthroscopic subacromial decompression : Results in advanced impingement syndrome. Arthroscopy, 7: , 1991.

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