Tauber Mark, Martetschläger Frank
Deutsches Schulterzentrum, ATOS Klinik München, Effnerstr. 38, 81925, München, Deutschland.
Paracelsus Medizinische Privatuniversität Salzburg, Salzburg, Österreich.
Orthopade. 2019 Sep;48(9):795-808. doi: 10.1007/s00132-019-03792-9.
Primary osteoarthritis of the shoulder represents a destructive joint disease with associated synovitis, which in the first line seems to be genetically determined. Clinically, patients suffer from shoulder pain with progressive impairment of both active and passive range of motion. The diagnostics include a clinical examination, imaging by native radiography and magnetic resonance imaging (MRI) for assessment of the rotator cuff. Current classification systems consider the formation of humeral osteophytes, glenoid morphology and loss of humeral sphericity. Non-surgical measures include, apart from topical and oral analgesics, injection of corticosteroids and hyaluronic acid supported by physiotherapeutic measures. After failure of non-surgical therapeutic measures, arthroscopic joint-preserving arthroplasty in terms of the comprehensive arthroscopic management (CAM) procedure can be performed in young patients with early stage osteoarthritis, whereas in advanced stages endoprosthetic joint replacement is indicated.
原发性肩关节骨关节炎是一种伴有滑膜炎的破坏性关节疾病，从一线研究来看，似乎由基因决定。临床上，患者会出现肩部疼痛，主动和被动活动范围逐渐受限。诊断方法包括临床检查、通过X线平片和磁共振成像（MRI）进行影像学检查以评估肩袖。目前的分类系统考虑肱骨骨赘的形成、关节盂形态和肱骨球形度的丧失。非手术措施除局部和口服镇痛药外，还包括注射皮质类固醇和透明质酸，并辅以物理治疗措施。非手术治疗措施失败后，对于早期骨关节炎的年轻患者，可根据综合关节镜治疗（CAM）程序进行关节镜下保关节成形术，而在晚期则需进行人工关节置换。
