2010 年 34 巻 2 号 p. 355-358
The purpose was to evaluate the clinical features and the results of arthroscopic surgery in patients over 40 years of age, who had recurrent dislocations of the shoulder without a full-thickness tear of the rotator cuff. There were 12 patients (male: 5, female: 7) who underwent arthroscopic surgery and were followed for more than 1 year. Their average age at surgery was 47 years old, ranging from 40 to 74 years. All patients underwent arthroscopic Bankart repair using suture anchors. Age at first injury, sports activity, arthroscopic findings, JSS-SIS, and the change of ROM after the surgery were evaluated.
Nine patients had the first dislocation of the shoulder in their twenties. In 4 patients, the interval without dislocation lasted for more than 10 years, even though their shoulders dislocated several times in their teens or twenties. The major reasons for surgery were inability to reduce the dislocation manually and interference with activities of daily living, and/or shoulder re-dislocation at the re-start of sports activities in women in their forties. The JSS-SIS was an average 51 points before the surgery, the pain score was average 10.5 points, and the ROM score average 15.3. That was average 92 points at the final follow-up. The ROM ratio versus the opposite side was 87% in elevation and 63% in external rotation at 6 months after surgery. These values improved to 92% and 80%, respectively, at 1 year after surgery, and had no statistical difference compared to those in patients less than 40 years of age. Arthroscopic Bankart repair for patients over 40 with recurrent dislocation of the shoulder produced satisfactory results. Postoperative limitation of ROM was decreased with the procedure.