Gomez Gregory V, Huffman G Russell
Department of Orthopaedic Surgery, Emanate Health Medical Group, Covina, CA, USA.
Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Winter Park, FL, USA.
JSES Rev Rep Tech. 2022 Jan 13;2(2):164-167. doi: 10.1016/j.xrrt.2021.12.005. eCollection 2022 May.
The incidence of reverse shoulder arthroplasty (RSA) has increased since the Food and Drug Administration approved its use in the United States in 2004. With the current RSA implants available for surgeon use within the United States of America, each design, regardless of humeral inlay vs. onlay, distalizes the shoulder's center of rotation. This new center of rotation purposely increases tension to the deltoid, which is the main working muscle in RSA, but also retensions the adjacent tendons. Some patients after RSA experience continued anterior shoulder discomfort that limits their active range of motion and overall patient satisfaction. It has been isolated with physical examination that there is tenderness to palpation at the coracoid process and throughout the conjoint tendon. We have completed conjoint tendon lengthening procedures on this subset of patients with excellent clinical results. This article describes the technique for patients who underwent conjoint tendon lengthening after RSA for recalcitrant anterior shoulder pain.
自2004年美国食品药品监督管理局批准反肩关节置换术（RSA）的使用以来，该手术的发病率有所上升。在美国，目前外科医生可用的RSA植入物中，无论采用肱骨嵌体还是覆盖式设计，每种设计都会使肩关节的旋转中心向远侧移位。这个新的旋转中心有意增加了三角肌的张力，三角肌是RSA中的主要作用肌，但同时也使相邻肌腱的张力发生了改变。一些接受RSA手术的患者术后仍持续存在肩部前方不适，这限制了他们的主动活动范围以及患者的总体满意度。体格检查发现，喙突及联合腱全程有压痛。我们对这部分患者进行了联合腱延长手术，取得了良好的临床效果。本文描述了RSA术后因顽固性肩部前方疼痛而接受联合腱延长手术的患者的手术技术。
