同種骨impaction bone graftを用いて上腕骨人工骨頭再置換術を行った1例

Revision Hemiarthroplasty of the Shoulder by the Impaction Bone Allograft Technique. Case Report

　左上腕骨近位端骨折に対して人工骨頭置換術が施行され，術後8年でステム先端部での上腕骨骨折，ステムの弛みと骨溶解が認められた70歳女性の人工骨頭再置換術について報告した．本例では保存的治療で骨癒合を得た後，同種骨impaction bone graftを用いた人工骨頭再置換術を行った．術後1年3カ月で骨量の再獲得と合わせて良好な固定性が得られ，疼痛が軽減し，日常生活動作の改善が得られた．同種骨impaction bone graftは上腕骨の再建においても選択肢の1つになり得ると思われた．

　We report a case of revision hemiarthroplasty of a shoulder by the impaction bone allograft technique. The patient was a 70-year-old woman who had undergone hemiarthroplasty of the shoulder for non-union of a humeral neck fracture. Eight years later she complained of pain in the upper arm, and radiography revealed a periprosthetic fracture and severe osteolysis around the humeral prosthesis. The humeral fracture was treated with a brace, and when union had been achieved two months later, revision hemiarthroplasty of the shoulder was performed by the impaction bone allograft technique. Radiography 16 months later revealed recovery of the bone stock and stable implant fixation. The pain had decreased, and there was improvement in activities of daily living. The impaction bone allograft technique is an option for the treatment of periprosthetic osteolysis of the humerus.