Shiota E, Matsumoto Y, Nakamoto M
Department of Orthopaedic Surgery, Chikushi Hospital, Fukuoka University, Japan.
J Shoulder Elbow Surg. 2000 Mar-Apr;9(2):89-92.
The clinical results of open surgical treatment for hemodialysis-related arthropathy in the shoulder were evaluated, and the pathology was investigated. Fifteen shoulders of 11 patients (6 female and 5 male) were treated during the past 6 years. The average age was 56.7 years. The duration of hemodialysis averaged 17.5 years. Simple curettage was performed in 7 shoulders, and curettage and bone graft were performed in 5 shoulders. Repair of the rotator cuff was performed in 3 shoulders. Pathologic foci always existed in the intertubercular sulcus and the greater tuberosity of the humerus. Marked proliferations of the bursa and multiple cystic bone lesions were found, and amyloid depositions were observed on histologic evaluation in all cases. Open surgical treatment was quite effective, and relief from the clinical symptoms was maintained for a satisfactory period of time. Enthesopathy induced by the amyloid deposition is considered the main pathology.
对肩部血液透析相关关节病的开放手术治疗临床结果进行评估，并对病理情况进行研究。在过去6年中，对11例患者（6例女性和5例男性）的15个肩部进行了治疗。平均年龄为56.7岁。血液透析平均时长为17.5年。7个肩部进行了单纯刮除术，5个肩部进行了刮除术及骨移植。3个肩部进行了肩袖修复。病理病灶总是存在于肱骨结节间沟和大结节处。发现滑囊明显增生和多处囊性骨病变，所有病例组织学评估均观察到淀粉样沉积。开放手术治疗相当有效，临床症状缓解维持了一段令人满意的时间。淀粉样沉积引起的附着点病被认为是主要病理改变。
