Glenohumerale Arthrolyse der Omarthroseschulter bei anatomischer Schulterprothesenimplantation

Abstract

Pain reduction and improvement of range of motion. Primary and secondary osteoarthritis, unsuccessful conservative treatment, limited range of motion with capsular contraction. General contraindications for anatomical total shoulder arthroplasty. Instability arthritis without capsular contraction. Deltopectoral approach. Detachment and release of the subscapularis tendon at the lesser tuberosity, incision of the anterior and inferior humeral sided capsule and osteophyte removal, humeral head resection and stem preparation. Glenoid exposure, capsular an labral resection. Glenoid surface preparation and prosthetic component implantation. Anatomical placement of the the humeral head without overstuffing. Implantation of the final humeral stem. Transosseous refixation of the subscapularis tendon. Wound closure. Abduction brace for 4weeks. Assisted motion starting the first postoperative day during the first 6weeks: anteversion/ retroversion 90-0-0°, abduction/ adduction 90-0-20°, internal/external rotation 90-0-individual limitation. Subsequent development of full range of motion. In 2009 and 2010 anatomical total shoulder arthroplasty with glenohumeral arthrolysis was performed in 53cases. At an average follow up of 32months the Constant score and range of motion improved significantly. The complication rate was 9%.