高齢者の Cuff Tear Arthropathy に対する CTA 人工骨頭置換術の経験

概要

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The purpose of this study was to evaluate the clinical outcome after CTA head hemiarthroplasty has been performed on older patients of cuff tear arthropathy. From 2006, six patients with cuff tear arthropathy, without superior humeral escape (Seebauer IA, 3 cases and IIA, 3 cases) were treated with CTA head hemiarthroplasty. There were 1 male and 5 females. The average age at the time of surgery was 75.5 years (ranged 64-88 years). Depuy Global Advantage CTA head was used in 5 cases and Biomet Bio-Modular EAS head was used in one case. All prosthesis were non-cemented types. Patients were evaluated based on JOA scores, range of motion, and X-P. Patient follow-up averaged 25.3 months (ranged 12-36 months). Patients showed significant improvement in JOA score (32.2 to 68.2), pain score (6 to 19), function (7 to 12), forward flexion (29 degrees to 89 degrees) and external rotation (27 degrees to 45 degrees). All patients were satisfied with diminished pain, but still had some problems in ADL. There was no hardware loosening or acromion wear. CTA head hemiarthroplasty appears to provide reasonable short-term results for older patients of cuff tear arthropathy. However, hemiarthroplasty with muscle transfer or the reverse arthroplasty remains the treatment of choice for functional recovery.