Glenohumerale Arthrolyse der Omarthroseschulter bei anatomischer Schulterprothesenimplantation

Aim of the operation

Pain reduction and improvement of range of motion.

Indications

Primary and secondary osteoarthritis, unsuccessful conservative treatment, limited range of motion with capsular contraction.

Contraindications

General contraindications for anatomical total shoulder arthroplasty. Instability arthritis without capsular contraction.

Operative technique

Deltopectoral approach. Detachment and release of the subscapularis tendon at the lesser tuberosity, incision of the anterior and inferior humeral sided capsule and osteophyte removal, humeral head resection and stem preparation. Glenoid exposure, capsular an labral resection. Glenoid surface preparation and prosthetic component implantation. Anatomical placement of the the humeral head without overstuffing. Implantation of the final humeral stem. Transosseous refixation of the subscapularis tendon. Wound closure.

Follow-up treatment

Abduction brace for 4 weeks. Assisted motion starting the first postoperative day during the first 6 weeks: anteversion/ retroversion 90-0-0°, abduction/ adduction 90-0-20°, internal/external rotation 90-0-individual limitation. Subsequent development of full range of motion.

Results

In 2009 and 2010 anatomical total shoulder arthroplasty with glenohumeral arthrolysis was performed in 53 cases. At an average follow up of 32 months the Constant score and range of motion improved significantly. The complication rate was 9%.