Luenam Suriya, Kosiyatrakul Arkaphat
Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Bangkok 10400, Thailand.
Case Rep Orthop. 2013;2013:426102. doi: 10.1155/2013/426102. Epub 2013 Sep 19.
The glenohumeral joint tuberculosis (TB) is rare as compared with other joints. Plaster immobilization, arthrodesis, and resection arthroplasty have been proposed as the additional treatments with anti-TB medications in severe destructive arthritis. To our knowledge, however, the surgical treatment with shoulder arthroplasty has never been reported. We present two cases of active TB with unsalvageable glenohumeral joint. The cementless hemishoulder arthroplasties were performed immediately following the radical debridement. Anti-TB medications were given for 12 months after the surgery. Postoperatively, the patients were satisfied with the rapid symptomatic relief and significant functional recovery. With the follow-up period of 5 years, the operative results were still satisfactory and the reactivation of the infection was not detected.
与其他关节相比，肩肱关节结核较为罕见。对于严重破坏性关节炎，有人提出在使用抗结核药物的基础上，采用石膏固定、关节融合术和切除关节成形术作为辅助治疗方法。然而，据我们所知，尚未有关于采用肩关节成形术进行手术治疗的报道。我们报告两例肩肱关节无法挽救的活动性结核病例。在彻底清创后立即进行了非骨水泥半肩关节成形术。术后给予抗结核药物治疗12个月。术后，患者对症状迅速缓解和功能显著恢复感到满意。在5年的随访期内，手术效果仍然令人满意，未检测到感染复发。
