人工肩関節の緩みに対し再置換術を行い良好な成績を得た一例

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We performed a revision surgery for the loosening of the total shoulder arthroplasty and achieved good result. A 63 years old man visited our hospital with pain in his operated shoulder which had gotten worse. He was diagnosed with humeral head necrosis, and had total shoulder arthroplasty performed seventeen yeakrs ago. The findings of the first visit was tenderness in right upper arm . The range of motion (ROM) was 65° for active elevation(passive110°), external rotation 45°(90°) Internal rotation Th7 (Th7) Plain X-ray and CT showed the distal tip of the humeral shaft component protruded from the humerus, and thinning of posterior glenoid wall. We performed revision surgery after one month at first visit. The humeral shaft component was unstable and removed easily. We performed tri-cortical iliac bone graft to reconstruct the glenoid surface. Hydroxy apatite block was pushed into the glenoid cavity space. Humeral shaft component replacement with cement fixation was done. At 4.5years after the operation, his shoulder had no pain, The range of motion of his shoulder improved. In x-ray and CT findings good joint congruently was observed.