2023-09-05 01:20:12
Reporter Park Jeong-ryeol of Money Today | 2023.09.05 10:20
[박정렬의 신의료인]
For patients complaining of severe pain and functional impairment due to joint wear due to rupture of the shoulder tendon (rotator cuff), ‘retrograde artificial joint replacement’ using shoulder-only navigation is emerging as an alternative.
82-year-old Kim Mi-yeon (pseudonym), who underwent surgery to repair a torn rotator cuff three years ago. Last month, he suddenly felt severe pain in his shoulder and went to the hospital, where he was diagnosed with arthritis as his rotator cuff ruptured again. He was frustrated when the doctor said that his rotator cuff was too damaged to be sutured, but fortunately he was able to escape from the excruciating pain with ‘retrograde artificial joint replacement’, which inserts an artificial joint without suturing the torn tendon.
The rotator cuff, the four tendons that make up the shoulder, is the source of strength and guarantees freedom of movement. The problem is that the rotator cuff can easily tear if you are old enough to use it a lot or if you enjoy intense exercise. In particular, ‘rotator cuff arthropathy’, which causes shoulder arthritis due to neglect of a torn rotator cuff, is not easy to treat. The risk of re-rupture is high even if tendons and muscles are degenerated into fat and sutured.
As a treatment for such rotator cuff arthropathy, retrograde artificial joint replacement using computer navigation is attracting attention. The shoulder joint is connected to the ‘joint fossa’, where the ‘humeral head’ in the upper part of the arm is recessed in the body, like a golf ball on top of a golf tee. The arm is lifted with the power of the rotator cuff wrapped around it. On the other hand, retrograde joint replacement surgery changes the role of bone. An artificial joint in the shape of a ‘humeral head’ on the body side and a ‘joint fossa’ on the arm side connects the two.
Hallym University Dongtan Sacred Heart Hospital Orthopedic Professor Gyu-cheol Noh (Director) said, “Through this, if the center of rotation of the shoulder joint is moved outward and downward, it is possible to lift the arm with the power of the deltoid muscle without restoring the torn rotator cuff.” In addition to arthropathy, it is an effective treatment for patients with severe rotator cuff tear, such as severe bone loss due to rheumatoid arthritis or severe joint damage and wear.”
Retrograde artificial joint replacement is a high-level operation that replaces two shoulder joints with artificial joints. The method is complex and even with minor errors, side effects may occur after surgery. Since the shoulder joint is anatomically narrow, it is difficult for the surgeon to secure the field of view.
Complementing this is a computer navigation system dedicated to the shoulder. An infrared camera tracks the position of the surgical site and accurately informs the angle and location of the artificial joint to be inserted. You can feel the three-dimensional effect of the 3D image, so the accuracy is so high that the margin of error is less than 2 degrees. Problems such as unnecessary protrusion of screws or excessive bone removal can be prevented, and complications due to surgery can be minimized.
Director Noh Gyu-cheol of the hospital said, “Using navigation, we can accurately measure the angle, thickness, and spacing of bones to find the optimal position for an artificial joint. “An artificial joint, which can be used for an average of 15 years, will also be able to be used for a long time without shortening its lifespan.”
[저작권자 @머니투데이, 무단전재 및 재배포 금지]
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#treatment #tattered #shoulder #tendons #artificial #joints #stitches