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논문 기본 정보

자료유형
학술저널
저자정보
Michael D. Scheidt (Loyola University Medical Center) Saleh Aiyash (Huntington Memorial Hospital) Dane Salazar (Loyola University Medical Center) Nickolas Garbis (Loyola University Medical Center)
저널정보
대한견주관절의학회 대한견주관절의학회지 대한견주관절의학회지 제26권 제2호
발행연도
2023.6
수록면
191 - 204 (14page)

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초록· 키워드

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Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

목차

INTRODUCTION
PATHOGENESIS AND ETIOLOGY
CLINICAL PRESENTATION
RADIOLOGIC ASSESSMENT
CLASSIFICATION
NONOPERATIVE MANAGEMENT
CORE DECOMPRESSION INDICATIONS
CORE DECOMPRESSION TECHNIQUES AND OUTCOMES
CONCLUSIONS
REFERENCES

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