Wülker N
Orthopädische Klinik der Medizinischen Hochschule, Heimchenstrasse 1-7, 30625 Hannover.
Orthopade. 2000 Oct;29(10):909-16.
Degenerative arthrosis of the shoulder is less commonly diagnosed than at the joints of the lower extremity. The shoulder joint does not bear weight and some of the mechanical stresses are taken up by the subacromial space. However, anatomical studies reveal a significant incidence of degenerative changes at the glenohumeral joint with increasing age. Arthrosis is caused by mechanical loading, rotator cuff defects, and abnormal joint motion following surgery. Clinical symptoms are rarely focused on the glenohumeral joint. Clinical findings are also unspecific. Rotation of the elevated arm with compression of the joint is a reliable sign of arthrosis. The diagnosis is made with anteroposterior and axial radiographs. Ultrasonography should always be performed and computed tomography only in specific cases. Nonoperative treatment includes analgesic and antiphlogistic medication, motion therapy, and muscle exercises. Shoulder arthroplasty is favoured in advanced arthrosis. New prostheses are intended to reconstruct the normal anatomy as closely as possible.
与下肢关节相比，肩部退行性关节炎的诊断相对较少。肩关节不负重，一些机械应力由肩峰下间隙承担。然而，解剖学研究表明，随着年龄的增长，肱盂关节出现退行性改变的发生率显著增加。关节炎是由机械负荷、肩袖缺损以及手术后的异常关节运动引起的。临床症状很少集中在肱盂关节。临床检查结果也不具有特异性。抬高手臂并对关节施加压力时的旋转是关节炎的可靠体征。通过前后位和轴位X线片进行诊断。应始终进行超声检查，仅在特定情况下进行计算机断层扫描。非手术治疗包括止痛和消炎药物、运动疗法以及肌肉锻炼。对于晚期关节炎，肩关节置换术是首选。新型假体旨在尽可能接近地重建正常解剖结构。
