Charcot肩関節症に対する人工骨頭置換術および腱板再建術

Humeral Head Replacement with Rotator Cuff Reconstruction in Patient with Neurotrophic Arthropathy of the Shoulder Joint

　神経病性肩関節症であるCharcot肩関節症は非常に稀な疾患であり，その肩関節機能低下は重度である．これまで種々の治療法が報告されているにもかかわらず中長期の報告はなく，一定の治療見解はいまだ不明である．われわれは脊髄空洞症に伴う3例のCharcot肩関節症に対し人工骨頭置換術と腱板再建術を施行してきた．5年以上の経過観察では，腫脹の軽減に有効であり，有用な機能改善が期待でき，画像上，人工関節の弛みも認めていない．しかし疼痛に関しては残存する可能性もあることを念頭に置く必要がある．

　Neurotrophic arthropathy of the shoulder is relatively rare problems.　No useful treatment for Charcot shoulder has been reported, and the reconstruction of Charcot's shoulder joint is a quite difficult problem.　We reported three cases with Charcot's shoulder joint which were performed humeral head replacement with rotator cuff reconstruction.　Humeral head replacement and rotator cuff reconstruction for Charcot's joint could be expected good functional of the shoulder, and there were no evidence of loosening and dislocation in radiographs.　However, pain relief was not complete after the shoulder reconstruction in such casas.