跳至主要内容

Rotator Cuff Reconstruction and Humeral Head Replacement Using Smaller Humeral Prostheses in Cuff Tear Arthropathy Patients under 70 Years of Age

Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50898#.VE8IfVfHRK0

Background: Most reverse shoulder arthroplasty (RSA) studies have shown good improvement in arm elevation without improvements in external rotation (ER). In addition, high rates of complications after long-term RSA have been reported, suggesting that RSA should be limited to elderly patients, especially those who are older than 70 years old. Since 2001, we have developed a strategy of rotator cuff reconstruction with muscle transfer and humeral head replacement (HHR), using smaller humeral prostheses, in cuff tear arthropathy patients. The aim of the present study was to investigate the clinical outcome of our strategy in patients under 70 years of age who had irreparable rotator cuff tears and osteoarthritis. Materials and Methods: A total of 25 shoulders of 25 patients under 70 years of age (males, 15; females, 10) with irreparable cuff tears were treated with HHR and cuff reconstruction. The average age at the time of surgery was 64.3 years (range, 55 - 69) and the average follow-up period was 38.7 months (range, 24 - 72). The cuff defect was repaired using a partial subscapularis transfer in 14 shoulders; nine shoulders required a latissimus dorsi transfer, one required a pectoralis major transfer, and one required both a latissimus dorsi and a pectoralis major transfer. Clinical outcomes were assessed with the range of motion (ROM), UCLA score, Japanese Orthopaedic Association (JOA) score and postsurgical complications. Results: Shoulder pain was diminished in all patients after surgery. The preoperative UCLA and JOA scores were 13.1 and 47.0 respectively, improving to 28.6 and 81.5 respectively after surgery. Active forward flexion has improved from an average of 89.0° to 138.8°, and the ER improved from an average of 16.2° to 33.2°. No complications occurred after surgery. Conclusion: Anatomical reconstruction using smaller head humeral prostheses yielded favorable results and less complication, compared with RSA. Considering another advantage of ability to retain glenoid bone stock, the current procedure can be a useful option for irreparable rotator cuff tears with OA in patients under 70 years old.
Cite this paper
Miyoshi, N. , Suenaga, N. , Oizumi, N. , Taniguchi, N. and Ito, H. (2014) Rotator Cuff Reconstruction and Humeral Head Replacement Using Smaller Humeral Prostheses in Cuff Tear Arthropathy Patients under 70 Years of Age. Open Journal of Orthopedics, 4, 263-272. doi: 10.4236/ojo.2014.410043. 
 

[1] Boileau, P., Watkinson, D., Hatzidakis, A.M. and Hovorka, I. (2006) The Grammont Reverse Shoulder Prosthesis: Results in Cuff Tear Arthritis, Fracture Sequelae, and Revision Arthroplasty. Journal of Shoulder and Elbow Surgery, 15, 527-540.
http://dx.doi.org/10.1016/j.jse.2006.01.003
[2] Favard, L., Levigne, C., Nerot, C., Gerver, C., Wilde, L.D. and Mole, D. (2011) Reverse Prostheses in Arthropathies with Cuff Tear: Are Survivorship and Function Maintained Over Time? Clinical Orthopaedics and Related Research, 469, 2469-2475.
http://dx.doi.org/10.1007/s11999-011-1833-y
[3] Guery, J., Favard, L., Sirveaux, F., Oudet, D., Mole, D. and Walch, G. (2006) Reverse Total Arthroplasty: Survivorship Analysis of Eighty Replacements Followed for Five to Ten Years. The Journal of Bone and Joint Surgery, 88, 1742-1747.
http://dx.doi.org/10.2106/JBJS.E.00851
[4] Sirveaux, F., Favard, L., Oudet, D., Huquet, D., Walch, G. and Mole, D. (2004) Grammont Inverted Total Shoulder Arthroplasty in the Treatment of Glenohumeral Osteoarthritis with Massive Rupture of the Cuff: Results of a Multicenter Study of 80 Shoulders. The Journal of Bone and Joint Surgery, 86, 388-395.
http://dx.doi.org/10.1302/0301-620X.86B3.14024
[5] Wall, B., Nove-Josserand, L., O’Connor, D.P., Edwards, T.B. and Walch, G. (2007) Reverse Total Shoulder Arthroplasty: A Review of Results According to Etiology. The Journal of Bone and Joint Surgery, 89, 1476-1485.
http://dx.doi.org/10.2106/JBJS.F.00666
[6] Werner, C.M.L., Steinmann, P.A., Gilbart, M. and Gerver, C. (2005) Treatment of Painful Pseudoparesis Due to Irreparable Rotator Cuff Dysfunction with the Delta III Reverse-Ball-and-Socket Total Shoulder Prosthesis. The Journal of Bone and Joint Surgery, 87, 1476-1486.
[7] Yamane, S., Suenaga, N., Oizumi, N. and Funakoshi, T. (2011) Total Shoulder Arthroplasty and Humeral Head Replacement for Osteoarthritis and Cuff Tear Arthropathy in Patients 75 Years Old and Older. Katakansetsu, 35, 641-644.
[8] Neer, C.S. 2nd, Craig, E.V. and Fukuda, H. (1983) Cuff Tear Arthropathy. The Journal of Bone and Joint Surgery, 65, 1232-1244.
[9] Arntz, C.T., Jackins, S. and Matsen, F.A. 3rd. (1993) Prosthetic Replacement of the Shoulder for the Treatment of Defects in the Rotator Cuff and the Surface of the Glenoid Joint. The Journal of Bone and Joint Surgery, 75, 485-491.
[10] Field, L.D., Dines, D.M., Zabinski, S.F. and Warren, R.F. (1997). Hemiarthroplasty of the Shoulder for Rotator Cuff Arthropathy. Journal of Shoulder and Elbow Surgery, 6, 18-23.
http://dx.doi.org/10.1016/S1058-2746(97)90066-5
[11] Goldberg, S.S., Bell, J.E., Kim, H.J., Bak, S.F., Levine, W.N. and Bigliani, L.U. (2008) Hemiarthroplasty for the Rotator Cuff-Deficient Shoulder. The Journal of Bone and Joint Surgery, 90, 554-559.
http://dx.doi.org/10.2106/JBJS.F.01029
[12] Goldberg, S.S. and Bigliani, L.U. (2009) Hemiarthroplasty for the Rotator Cuff-Deficient Shoulder Surgical Technique. The Journal of Bone and Joint Surgery, 91, 22-29.
[13] Pollock, R.G., Deliz, E.D., Mcllveen, S.J., Flatow, E.L. and Bigliani, L.U. (1992) Prosthetic Replacement in Rotator Cuff Deficient Shoulders. Journal of Shoulder and Elbow Surgery, 1, 173-186.
http://dx.doi.org/10.1016/1058-2746(92)90011-Q
[14] Sanchez-Sotelo, J., Cofield, R.H. and Rowland, C.M. (2001) Shoulder Hemiarthroplasty for Glenohumeral Arthritis Associated with Severe Rotator Cuff Deficiency. The Journal of Bone and Joint Surgery, 83-A, 1814-1822.
[15] Duralde, X.A. and Bair, B. (2005) Massive Rotator Cuff Tears: The Result of Partial Rotator Cuff Repair. Journal of Shoulder and Elbow Surgery, 14, 121-127.
http://dx.doi.org/10.1016/j.jse.2004.06.015
[16] Ha’eri, G.B. and Wiley, A.M. (1981) Advancement of the Supraspinatus Muscle in the Repair of Ruptures of the Rotator Cuff. The Journal of Bone and Joint Surgery, 63, 232-238.
[17] Labbe, M.R. (2006) Arthroscopic Technique for Patch Augmentation of Rotator Cuff Repairs. Arthroscopy, 22, 1136.e1-1136.e6.
[18] Aoki, M., Okamura, K., Fukushima, S., Takahashi, T. and Ogino, T. (1996) Transfer of Latissimus Dorsi for Irreparable Rotator-Cuff Tears. The Journal of Bone and Joint Surgery, 78-B, 761-766.
[19] Gerber, C. (1992) Latissimus Dorsi Transfer for the Treatment of Irreparable Tears of the Rotator Cuff. Clinical Orthopaedics and Related Research, 275, 152-160                                                eww141028lx
标签：

评论

发表评论

此博客中的热门博文

A Comparison of Methods Used to Determine the Oleic/Linoleic Acid Ratio in Cultivated Peanut (Arachis hypogaea L.)

Cultivated peanut ( Arachis hypogaea L.) is an important oil and food crop. It is also a cheap source of protein, a good source of essential vitamins and minerals, and a component of many food products. The fatty acid composition of peanuts has become increasingly important with the realization that oleic acid content significantly affects the development of rancidity. And oil content of peanuts significantly affects flavor and shelf-life. Early generation screening of breeding lines for high oleic acid content greatly increases the efficiency of developing new peanut varieties. The objective of this study was to compare the accuracy of methods used to classify individual peanut seed as high oleic or not high oleic. Three hundred and seventy-four (374) seeds, spanning twenty-three (23) genotypes varying in oil composition (i.e. high oleic (H) or normal/not high oleic (NH) inclusive of all four peanut market-types (runner, Spanish, Valencia and Virginia), were individually tested ...
发表评论
阅读全文

Location Optimization of a Coal Power Plant to Balance Costs against Plant’s Emission Exposure

Fuel and its delivery cost comprise the biggest expense in coal power plant operations. Delivery of electricity from generation to consumers requires investment in power lines and transmission grids. Placing a coal power plant or multiple power plants near dense population centers can lower transmission costs. If a coalmine is nearby, transportation costs can also be reduced. However, emissions from coal plants play a key role in worsening health crises in many countries. And coal upon combustion produces CO 2 , SO 2 , NO x , CO, Metallic and Particle Matter (PM10 & PM2.5). The presence of these chemical compounds in the atmosphere in close vicinity to humans, livestock, and agriculture carries detrimental health consequences. The goal of the research was to develop a methodology to minimize the public’s exposure to harmful emissions from coal power plants while maintaining minimal operational costs related to electric distribution losses and coal logistics. The objective was...
发表评论
阅读全文

Evaluation of the Safety and Efficacy of Continuous Use of a Home-Use High-Frequency Facial Treatment Appliance

At present, many home-use beauty devices are available in the market. In particular, many products developed for facial treatment use light, e.g., a flash lamp or a light-emitting diode (LED). In this study, the safety of 4 weeks’ continuous use of NEWA TM , a high-frequency facial treatment appliance, every alternate day at home was verified, and its efficacy was evaluated in Japanese individuals with healthy skin aged 30 years or older who complained of sagging of the facial skin.  Transepidermal water loss (TEWL), melanin levels, erythema levels, sebum secretion levels, skin color changes and wrinkle improvement in the facial skin were measured before the appliance began to be used (study baseline), at 2 and 4 weeks after it had begun to be used, and at 2 weeks after completion of the 4-week treatment period (6 weeks from the study baseline). In addition, data obtained by subjective evaluation by the subjects themselves on a visual analog scale (VAS) were also analyzed. Fur...
发表评论
阅读全文