應用全肩人工關節置換術治療嚴重骨關節炎－－術後十七個月之病例報告與分析

Total Shoulder Replacement Arthroplasty for Severe Osteoarthritis-- A Case Report with 17 Months Follow- up

肩部之嚴重關節炎須以全肩人工關節置換術治療之病例並不多見，全肩人工關節也遲至1972年才正式問世，而國內過去亦未見該項手術之報告。本例為一73歲之男性病人，因右肩嚴重骨關節炎，經保守療法與關節鏡清除術治療均無法控制，乃於民國74年12月接受全肩關節置換術，手術十七個月後之效果令人滿意。本文乃藉此病例將全肩人工關節置換術做一介紹性之報告。

Severe shoulder disability caused by arthritis needing total joint replacement is not common. The total shoulder prosthesis was not developed for clinical use until 1972 and there has been no previous report published in this country. A 73-year-old male with severe osteoarthritis which was not controllable with conservative management was treated succesfully with total shoulder replacement arthroplasty in December, 1985, The follow-up result has been satisfactory and encouraging. This case is analyzed and presented here as an introductory report regarding this relatively new surgical procedure. The frequently seen radiolucent line presenting at the bone-cement interface in the glenoid as reported by Neer et al and Cofield has also been noted in this case immediately after the operation. According to literature, the significance of this line has not been clear. The author believes it is, at least in part, related to the residual cartilage remaining on the articular surface of the glenoid cavity.