It
acts of the wear of the cartilage of the articulation
of the shoulder made up on a side by the head
of the humerus and other side by articular surface
of the scapula (called glene).
Symptoms :
the pains of the
shoulder known as Ňof mechanical paceÓ 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).
The 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
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......
