Witwity T, Uhlmann R, Nagy M H, Bhasin V B, Bahgat M M, Singh A K
Clinic of Arthroscopic Surgery and Sports Medicine, Germany.
Arthroscopy. 1991;7(2):233-6. doi: 10.1016/0749-8063(91)90112-b.
We present a case of rheumatoid arthritis that affected the right shoulder and was associated with chondromatosis and multiple loose body formation. The arthritis was treated arthroscopically with satisfactory results after a follow-up period of 15 months. In our case, arthroscopic debridement and partial synovectomy not only relieved the pain but also improved the range of motion the night after surgery. The multiple loose bodies irritating the synovium and causing effusion, crepitus, and locking were also removed. One may need to change portals of the scope and suction cannula to remove loose bodies in different joint spaces. The subacromial space must be searched for loose bodies. Thorough cleaning, lavage, and synovectomy are important parts of this surgery. The continuous passive motion (CPM) machine in the immediate postoperative period was helpful.
我们报告一例类风湿性关节炎累及右肩，并伴有滑膜软骨瘤病和多个游离体形成。该关节炎通过关节镜治疗，随访15个月后效果满意。在我们的病例中，关节镜下清创和部分滑膜切除术不仅缓解了疼痛，还在术后当晚改善了活动范围。刺激滑膜并导致积液、摩擦音和交锁的多个游离体也被清除。可能需要更换关节镜和吸引套管的入口，以清除不同关节间隙的游离体。必须在肩峰下间隙寻找游离体。彻底清洁、冲洗和滑膜切除术是该手术的重要组成部分。术后立即使用持续被动运动（CPM）机很有帮助。
