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帕金森病患者的反向全肩关节置换术:病例系列及文献综述

Reverse total shoulder arthroplasty in patients with parkinson disease: a case series and review of the literature.

作者信息

Dunn John, Byrne Abigail N, Higgins Laurence D

机构信息

Michigan State University, East Lansing, Michigan, USA.

出版信息

Am J Orthop (Belle Mead NJ). 2011 Dec;40(12):625-9.

Abstract

Parkinson disease (PD) is a chronic degenerative neurologic disorder with both motor and nonmotor facets. The motor symptoms, including increased risk for falls, fractures, and stiffness, contribute to the morbidity of arthroplasty. In this article, we report 3 cases of reverse total shoulder arthroplasty in patients with PD. All patients achieved poor functional outcomes with mean (range) active forward flexion of 40° (20°-60°) at follow-up. Although each patient obtained significant pain relief-mean (range) visual analog scale score was less than 1 (0-2)-range of motion was poor. In addition, each patient developed significant glenoid notching, though no component loosening or migration was observed. Mean (range) postoperative follow-up was 17 (4-32) months. A patient who has PD and requires an inverse arthroplasty should be counseled that pain relief may be reliably achieved, while functional outcomes are poor.

摘要

帕金森病(PD)是一种具有运动和非运动方面表现的慢性退行性神经疾病。其运动症状,包括跌倒、骨折和僵硬风险增加,会导致关节置换术的发病。在本文中,我们报告了3例帕金森病患者行反式全肩关节置换术的病例。所有患者随访时功能结局均较差,主动前屈平均(范围)为40°(20° - 60°)。尽管每位患者疼痛均得到显著缓解——视觉模拟量表评分平均(范围)小于1(0 - 2)——但活动范围较差。此外,每位患者均出现明显的肩胛盂切迹,不过未观察到假体松动或移位。术后平均(范围)随访时间为17(4 - 32)个月。对于患有帕金森病且需要进行反式关节置换术的患者,应告知其疼痛缓解可能可以可靠实现,但功能结局较差。

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