K Midorikawa1, M Hara, G Emoto, Y Shibata, M Naito. 1. Department of Orthopaedic Surgery, School of Medicine, Fukuoka University, Fukuoka, Japan. komidori@cis.fukuoka-u.ac.jp
Abstract
PURPOSE: To arthroscopically treat "dialysis shoulder," severe shoulder pain in patients on long-term hemodialysis. This pain occurs only at rest such as during hemodialysis or while sleeping and is temporarily alleviated by assuming the sitting position or moving the shoulder joint. Limitations in range of motion and pain with overhead activity or the arm in the forward flexed position are not the patient's chief complaints. Although frozen shoulder and impingement syndrome may be observed as complications, pain at rest is the most characteristic. TYPE OF STUDY: Clinical research on arthroscopic debridement to treat dialysis shoulder. METHODS: We performed arthroscopic debridement of 36 dialysis shoulders in 29 patients. Only complete debridement in the glenohumeral joint and subacromial bursa was performed, without invasion to the bone and ligaments. RESULTS: The pain improved in 34 shoulders in 27 patients (94%) a mean of 29.8 months after surgery, showing satisfactory results. In this group, the mean Japan Orthopaedic Surgery Association shoulder score (maximum 100 points) was 66.4 points before surgery but increased to 86.6 points postoperatively, statistically significant by 2-group t test. CONCLUSIONS: We decided before beginning the study that no postoperative rehabilitation would be necessary. There were no complications and no need for further surgery, with all but 2 of the patients being satisfied with their postoperative condition.
PURPOSE: To arthroscopically treat "dialysis shoulder," severe shoulder pain in patients on long-term hemodialysis. This pain occurs only at rest such as during hemodialysis or while sleeping and is temporarily alleviated by assuming the sitting position or moving the shoulder joint. Limitations in range of motion and pain with overhead activity or the arm in the forward flexed position are not the patient's chief complaints. Although frozen shoulder and impingement syndrome may be observed as complications, pain at rest is the most characteristic. TYPE OF STUDY: Clinical research on arthroscopic debridement to treat dialysis shoulder. METHODS: We performed arthroscopic debridement of 36 dialysis shoulders in 29 patients. Only complete debridement in the glenohumeral joint and subacromial bursa was performed, without invasion to the bone and ligaments. RESULTS: The pain improved in 34 shoulders in 27 patients (94%) a mean of 29.8 months after surgery, showing satisfactory results. In this group, the mean Japan Orthopaedic Surgery Association shoulder score (maximum 100 points) was 66.4 points before surgery but increased to 86.6 points postoperatively, statistically significant by 2-group t test. CONCLUSIONS: We decided before beginning the study that no postoperative rehabilitation would be necessary. There were no complications and no need for further surgery, with all but 2 of the patients being satisfied with their postoperative condition.