腱板断裂関節症に人工骨頭置換と L'Episcopo 変法を行った1例

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Reverse shoulder prosthesis is often used for irreparable rotator cuff tear with arthritis. Recently, reverse shoulder prosthesis with modified LEpiscopo procedure has been reported. We performed hemiarthroplasty together with modified LEpiscopo procedure to restore external rotation power with the arm at side in a patient who had cuff tear arthropathy. A 75-year-old female, right handed, complained of pain and weakness in the right shoulder. The pain acutely developed when she lifted the bedclothes in December, 2006. She consulted an orthopedist and underwent arthroscopic operation in February, 2007. She visited our hospital in September, 2007, because her complaints did not improve at all. On examination, the shoulder range of motion was 70 degrees in forward elevation, -20 degrees in external rotation, and right buttock in internal rotation posteriorly. She had an external rotation lag sign. Radiographs revealed osteoarthritis and magnetic resonance imaging (MRI) identified a rupture and fat degeneration of supraspinatus and infraspinatus tendons. We performed hemiarthropalsty using a bipolar prosthesis and modified LEpiscopo procedure through the deltopectoral interval in January, 2008. Postoperatively, the shoulder was immobilized in a splint in external rotation for 6 weeks; elevation and rotation exercises were encouraged thereafter. The external rotation lag sign disappeared six weeks after surgery. Six months after surgery, the shoulder range of motion was forward elevation; 80 degrees, external rotation; 30 degrees, internal rotation; L1. Hemiarthropalsty associated with modified LEpiscopo procedure can be a method to restore external rotation power with the arm at side in irreparable cuff tear with arthritis.
2010-08-04

腱板断裂関節症に人工骨頭置換と L'Episcopo 変法を行った1例

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