| Theme |
Orthopedic Diseases Seen in Maintenance Dialysis Patients -- Surgical Indication and Non-indication |
| Title |
Haemodialysis shoulder |
| Author |
Hiroyuki Hashizume |
Department of Orthopaedic Surgery, Kasaoka Daiichi Hospital |
| Author |
Ryouzou Sato |
Department of Orthopaedic Surgery, Kasaoka Daiichi Hospital |
| Author |
Kazuhiro Harada |
Department of Internal Medicine, Kasaoka Daiichi Hospital |
| Author |
Mitsuru Nagoshi |
Department of Orthopaedic Surgery, Kasaoka Daiichi Hospital |
| [ Summary ] |
Spontaneous shoulder pain in supine position (SPSP) induced by dialysis-related amyloidosis is a characteristic symptom which occurs in over-10-year long-term haemodialysis patients. The main cause of SPSP is an increase in subacromial pressure induced by amyloid deposits in the subacromial bursa and rotator cuff. These lesions can be treated with a minimally invasive endoscopic coraco-acromial ligament release (ECLR) procedure with the goal being the decompression of the subacromial space. 100 patients (133 shoulders) who had received dialysis for an average of 15 years underwent ECLR procedures under local anesthesia．The mean follow-up period was 3 years and 3 months. SPSP immediately disappeared in 92% of the cases. The average JOA score improved from 62 to 90 after the operations. The early recurrence rate was 5% (7 shoulders), for which additional ECLR was required. ECLR was not an effective modality for 11 shoulders. |