人工肩关节置换.ppt

人工肩关节置换
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Ways of reconstructions
Bone cement Iliac bone
Osteoarticular allograft arthrodesis
e
3 aggressive
malignant tumor
stage grade location metastatic
IA low in not
IB low out not
IIA high in not
IIB high out not
III any any yes
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Malawer classification of shoulder girdle resections
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TypeⅠ resection
Intra-articular proximal
humeral resection
TypeⅠA:abductors retained
TypeⅠB:abductors resected
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Magnetic resonance imaging (MRI)
Margin of resection
A margin of 3 to 4cm distal to the
MRI
extent of the tumor is sufficient
and allows a type ⅠA resection
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Margin of resection
Confined to bone
Intramedullary
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Margin of resection
Extraosseous extension that involves the deltoid, a typeⅠB resection will be required
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Prosthesis Implantation
Hemiarthroplasty
TSA
﹖
ⅠB
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Comparison
Hemiarthroplasty
TSA
Simlper procedure
Avoid loosening
and instability
Pain relief
Activity
Active range of motion
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Despite
the increased technical difficulty
,longer operating time,
and potential complications
associated with the glenoid component,
TSA appears to be our choice
Choice
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Rotator cuff
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Rotator cuff
支点
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Soft tissue reconstruction
type ⅠA

resection
Deltoid
（Supraspinatus）
Rotator cuff
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15%
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Dacron tape
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Enhance tendon anchor(ETA)
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Soft tissue reconstruction
type ⅠB

resection
Obtain stability
Mobilization
(Dacron tape)
elbow
hand
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