腱板断裂関節症に対する人工骨頭置換術および人工肩関節置換術

概要

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Background: The purpose of this study was to evaluate the clinical outcome after hemiarthroplasty (HHR) and total shoulder arthroplasty (TSA) using small diameter head, which have been performed on older cuff tear arthropathy (CTA) patients. Methods: From 2006, seventeen patients with CTA were treated operatively.Of those, 7 patients did not have superior humeral escape and those patients were treated with HHR or TSA using small diameter head. There were 1 male and 6 female patients. The average age at the time of surgery was 76.1 years old (ranged 72-81 years). Depuy Global Advantage was used in all cases. All humeral stems were non-cemented types. Patients were evaluated based on JOA scores, range of motion and X-ray. Patient follow-up averaged 15.7 months (ranged 6-28 months). Results: Patients showed significant improvement in JOA score (46.2 to 80.7), forward flexion (70 degrees to 122 degrees) and external rotation (17 degrees to 51 degrees). All patients were satisfied with diminished pain. There was no hardware loosening or superior migration. Discussion: HHR and TSA using small diameter head with cuff repair appeared to provide reasonable short-term results for older cuff tear arthropathy patients. This method remains the treatment of choice for functional recovery.