the pains of the shoulder known as “of mechanical
pace” occurring after physical efforts ;
a reduction in articular mobilities by ankylosis
of the articulation (consequence of a reduction in
the capacities of slip of the 2 articular surfaces).
Diagnosis
:
X-ray of the shoulder show a pinching of the articular
line space by disappearance of the cartilage: the
bone of the humerus is in contact with the bone of
glene of the scapula ;
the MRI can sometimes supplement the assessment
when a rupture of the tendons is suspected because,
in this case, the tendons will be repaired during
the operation.
X-ray of a shoulder sits
of a osteoarthritis
Treatment
:
The treatment must always be medical
initially acting on the pain; when the drugs are not
enough, physiotherapy (using devices such infra-red
type or ultrasounds or laser acting on the pain) can
be carried out.
If all these therapeutic did not generate
improvement, the surgery can be discussed.
Principle
:
to remove injured cartilage and to replace them
by a prosthesis of shoulder which is made up of 3
parts: the stem fixed in the channel of the humerus
and receiving the head of the humerus which is articulated
with the scapula by an implant fixed in the glene
of the scapula :
Prosthesis of the shoulder
in certain cases being associated with a rupture
of the tendons, those are repaired and fixed
firmly at the implant humeral allowing an immediate
rehabilitation.
Radiograph after implantation
of the prosthesis
Advantages
:
The implants profited from significant technical improvements
these last years :
the implants have their size reduced allowing more
limited dissections and more reduced osseous removed
allowing immediate rehabilitation after the operation
;
their implantation thus is facilitated of it making
it possible to reduce the duration of the operation;
their implantation is also more precise and is adapted
better to the anatomy of the patient thanks to a more
powerful instrumentation.
Limits
: Total ankylosis of the shoulder ; associated neurological
disease ; antecedent of chronic
infectious processes…
