Abstract
No standard treatement for hemodialysis shoulder arthropathy (HDS) has been established yet. We performed arthroscopic surgery in 5 shoulders of 5 cases, 3 males and 2 females. The average age was 62 years and the average term of hemodialysis 11 years. The cases were divided into two types, synovitis type with remarkable joint effusion and swelling (Type 1) and “so-called hemodialysis shoulder” by Okutsu (Type 2). Only synovectomy was performed for the Type 1, and subacromial decompression, including C-A ligament release and/or acromioplasty, was added for the Type 2. The JOA score for the shoulder joint was remarkably improved postoperatively (from 52 points to 92 for the type 1 and from 61 to 92 for the Type 2). One case of the Type 1, in which only synovectomy was performed, developed a recurrence of shoulder pain attributable to the impingement. Pathological synovial proliferation of the glenohumeral joint, which may damage the articular cartilage, was found in all cases. From the above facts, a combination of synovectomy and subacromial decompression may give better long term results.
