臨床整形外科53巻6号

2018年06月発行

Lecture

凍結肩の病態と治療

著者： 小出将志¹ 萩原嘉廣¹

所属機関： ¹東北大学大学院医学系研究科スポーツ・運動機能再建医学寄附講座　東北大学病院臨床研究推進センター

ページ範囲：P.507 - P.511

はじめに

　凍結肩は全人口の約2〜5％程度が罹患するcommon diseaseとして知られている¹⁾．近年，肩関節疾患に対して鏡視下手術が普及し，関節内の詳細な病変の確認および診断が可能となった．凍結肩の分子生物学的な手法による病態解明が進んできてはいるが^2-4)，いまだその全容は明らかではない．また，肩関節は肩甲上腕関節のみではなく，胸郭を構成する胸椎・肋骨・鎖骨・肩甲骨の動きと連動することが，凍結肩の病態解明をさらに難しくしている．本稿では，凍結肩の病態と治療について述べる．

参考文献

1) Sheridan MA, Hannafin JA. Upper extremity:emphasis on frozen shoulder. Orthop Clin North Am 2006;37:531-9.

2) Rodeo SA, Hannafin JA, Tom J, et al. Immunolocalization of cytokines and their receptors in adhesive capsulitis of the shoulder. J Orthop Res 1997;15:427-36.

3) Bunker TD, Reilly J, Baird KS, et al. Expression of growth factors, cytokines and matrix metalloproteinases in frozen shoulder. J Bone Joint Surg Br 2000;82:768-73.

4) Hagiwara Y, Ando A, Onoda Y, et al. Coexistence of fibrotic and chondrogenic process in the capsule of idiopathic frozen shoulders. Osteoarthritis Cartilage 2012;20:241-9.

5) Duplay ES. De la perarthite scapula-humerale. Rev Frat Trav Med 1896;53:226.

6) Codman EA (ed). The Shoulder:Rupture of the Supraspinatus Tendon and Other Lesions in or about the Subacromial Bursa. Boston:Thomas Todd;1934.

7) Zuckerman JD, Cuomo F. Frozen shoulder. 3rd ed. In:Matsen FA, Fu FH, Hawkins RJ (eds) Rosemont IL:American Academy of Orthopaedic Surgeons;1993.

8) 萩原嘉廣，井樋栄二．凍結肩の診断と保存的治療．MB Orthop 2012：25：87-91．

9) Lequesne M, Dang N, Bensasson M, et al. Increased association of diabetes mellitus with capsulitis of the shoulder and shoulder-hand syndrome. Scand J Rheumatol 1977;6:53-6.

10) Morén-Hybbinette I, Moritz U, Scherstén B. The clinical picture of the painful diabetic shoulder--natural history, social consequences and analysis of concomitant hand syndrome. Acta Med Scand 1987;221:73-82.

11) Fisher L, Kurtz A, Shipley M. Association between cheiroarthropathy and frozen shoulder in patients with insulin-dependent diabetes mellitus. Br J Rheumatol 1986;25:141-6.

12) Endres NK, ElHassan B, Higgins LD, et al. The stiff shoulder. In:Rockwood CA, Matsen F, Wirth M, et al (editors). The Shoulder. 4th ed. Philadelphia, Saunders, WB 2009;p.1405-36.

13) Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975;4:193-6.

14) Warner JJ, Allen A, Marks PH, et al. Arthroscopic release for chronic, refractory adhesive capsulitis of the shoulder. J Bone Joint Surg Am 1996;78:1808-16.

15) Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am 1992;74:738-46.

16) 沖田　実．関節可動域制限とは．沖田　実(編)．関節可動域制限．第2版．東京：三輪書店；2013．p.2-20．

17) Tamai K, Yamato M. Abnormal synovium in the frozen shoulder:a preliminary report with dynamic magnetic resonance imaging. J Shoulder Elbow Surg 1997;6:534-43.

18) Neviaser JS. Arthrography of the shoulder joint:study of the findings in adhesive capsulitis of the shoulder. J Bone Joint Surg Am 1962;44:1321-59.

19) 浜田純一郎．肩関節拘縮の病態と治療．MB Orthop 2002；15：57-63．

20) 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.

21) Hand GC, Athanasou NA, Matthews T, et al. The pathology of frozen shoulder. J Bone Joint Surg Br 2007;89:928-32.

22) Kanazawa K, Hagiwara Y, Kawai N, et al. Correlations of coracohumeral ligament and range of motion restriction in patients with recurrent anterior glenohumeral instability evaluated by magnetic resonance arthrography. J Shoulder Elbow Surg 2017;26:233-40.

23) 浜田純一郎．肩疾患に対する肩複合体の機能的診察法．MB Orthop 2012；25：1-7．

24) 高瀬勝己．治療　肩関節拘縮(凍結肩)をどう治療するか？　各保存療法の治療効果の比較．MB Orthop 2014；27：23-8．

25) Grant JA, Schroeder N, Miller BS, et al. Comparison of manipulation and arthroscopic capsular release for adhesive capsulitis:a systematic review. J Shoulder Elbow Surg 2013;22:1135-45.

26) Hagiwara Y, Ando A, Kanazawa K, et al. Arthroscopic coracohumeral ligament release for patients with frozen shoulder. Arthrosc Tech 2017;7:e1-e5.