進行したリウマチ肩に対する烏口突起骨移植を併用した人工骨頭置換術

概要

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We reported on hemiarthroplasty for rheumatoid arthritis with coracoid transplantation to the glenoid. From 2002 to 2005, 11 patients (8 women and 3 men ranging from 51 to 76 year old), 12 shoulders (right 6, left 6) were treated. The mean follow-up was 3.5 years (from two years to 5 years and 4 months). Our surgical technique was composed of coracoid transplantation to the glenoid with screws and hemiarthroplasty. We preserved the coracoid-acromion ligament by abrading subperiost from the coracoid. We used the JOA score system to assess the results. Pain relief was obtained in most of the patients. The JOA score improved from the average of 39 points preoperatively to 81 points postoperatively. Concerning the patients with rheumatoid arthritis, good exposure of the operative field could not be obtained easily because of the medialization of the humeral head. Our method, coracoid osteotomy is not only effective for good exposure of the operative field but also for the bone stock of the glenoid destruction.
日本肩関節学会の論文