腱板断裂手術後に残存する痛みの要因について Contracture of the Glenohumeral Joint as One of the Reasons for a Slight Postoperative Pain in Patients with a Rotator Cuff Tear
The outcome of surgery for rotator cuff tears has been reported to be excellent and most patients are satisfied with it. However, slight pain frequently remains after surgery and a number of patients complain of it postoperatively. Our previous studies demonstrated that a contracture of the glenohumeral joint together with an abnormal scapular position was associated with postoperative pain. The purpose of this study was to find out by arthrography at which site within the glenohumeral joint the contracture occurs most frequently.<BR>Glenohumeral arthrography was performed on 36 patients around one year after a McLaughlin proc edure. Of the 36 patients,21 presented slight postoperative pain. The range of age, size of the tear and preoperative JOA score in the patients with a postoperative pain were close to those in patients without pain. The anteroposterior (AP) view as well as the scapular Y view were taken with the arm at the side, and in neutral rotation. The size of the anterior and inferior pouches was measured in the AP arthrogram, and that of the anterior, inferior and posterior pouches in the scapular Y arthrogram, and the values were standardized by dividing those by the diameter of the humeral head.<BR>There were no significant difference in the size of the anterior and inferior pouches measured on the AP arthrogram between the patients with postoperative pain and those without pain. The size of the inferior pouch measured on the scapular Y view arthrogram, however, was significantly smaller in those patients with postoperative pain than in those without pain (p<0.01). The contracture in the inferior pouch appeared to be related to postoperative pain.<BR>Since slight postoperative pain was closely related to the contracture of the glenohumeral joint, it would be important to alleviate the contracture of the inferior pouch at an early stage postoperatively for pain relief.
- 肩関節 = Shoulder joint
肩関節 = Shoulder joint 24(2), 279-282, 2000-07-31