Der Oberflächenersatz am Schultergelenk
| Autor: | Martin Fuerst, Oliver Niggemeyer, Wolfgang Rüther |
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| Rok vydání: | 2009 |
| Předmět: | |
| Zdroj: | Aktuelle Rheumatologie. 34:22-26 |
| ISSN: | 1438-9940 0341-051X |
| Popis: | Rheumatoid arthritis often leads to severe destruction of the glenohumeral joint, including synovitis and inflammation-induced alterations of the rotator cuff. Cup arthroplasty, or surface replacement of the shoulder, was introduced in the 1980 s. The aim of this study is to evaluate the mid-term results of the DUROM cup surface replacement for patients with rheumatoid arthritis. Our experience with the DUROM cup surface replacement shows that it is as effective as modern stemmed shoulder hemiarthroplasties without the typically stem-associated problems. A more valgus position and subsequent articulation with the acromion is, according to the findings of this study, at least one key element for positive, functional results in patients with massive rotator cuff tears. Within the number of patients studied, no differences in clinical outcome were identified between those patients with a massive rotator cuff tear and those with smaller or no tears. Extended humeral-head necrosis along with sub-capital humeral-head fractures are contraindications to surface replacement of the humeral head. Cup arthroplasty is not suitable in cases where there is humeral head bone loss of more than 40% or where there is an insufficient amount of surface to replace, or where the bone that is too soft provide adequate fixation. The mid-term results of the cemented DUROM cup surface replacement for patients with advanced rheumatoid arthritis of the shoulder are very encouraging, including those patients with massive tears of the rotator cuff. The advantage of this cup arthroplasty is to be found in the less complex, bone-sparing surgery. In the event of failure of the implant, other reliable salvage options remain open. |
| Databáze: | OpenAIRE |
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