INTRODUÇÃOA condromatose sinovial primária do ombro é uma situação clínica rara, que cursa com a formação de múltiplos corpos livres intra-articulares nos vários compartimentos da articulação glenoumeral. O presente relato de caso tem como objetivo mostrar que a artroscopia permitiu visualizar todos os compartimentos intra-articulares acometidos, retirar os corpos livres e realizar a sinovectomia.
RELATO DO CASOPaciente do sexo feminino, 23 anos de idade, com história de dor no ombro direito havia cerca de um ano, sem história de traumatismo. Durante o exame físico, a paciente apresentava dor à movimentação do ombro e limitação da amplitude de movimento (100º de elevação anterior, 45º de rotação externa, rotação interna em T8 e 45º de abdução) (figura 1).Estudos por imagem foram obtidos através de radiografias simples e artrorressonância magnética, os quais demonstraram múltiplos corpos livres intra-articulares e osteoartrose glenoumeral incipiente (figura 2).
RESUMOOs autores descrevem caso raro de condromatose sinovial do ombro e seu tratamento cirúrgico. A artroscopia possibilitou a visualização de todos os compartimentos da articulação glenoumeral, permitindo a remoção dos corpos livres e realização da sinovectomia.
ObjectiveTo demonstrate the in situ repair technique of high-degree partial-thickness articular surface lesions of the supraspinatus tendon (SS). The procedure consists of the arthroscopic surgical repair of these lesions, without the need to complete the lesion, as occurs in traditional classical technique. A small incision is made in the longitudinal direction of the intact bursal fibers and where bone fixation anchors are introduced, which makes the procedure easier. These anchors are transferred to the tendon and thus enable the repair of the lesion.Methods48 shoulders were operated in the period 2010–2015. The minimum follow-up was 12 months and maximum 60 months. Ages ranged from 38 years to 75 years (mean 54 years). They were indicated for the repair of high-degree symptomatic lesions and at least 30% intact superior bursal fibers of good quality.ResultsPatients were evaluated according to the UCLA criteria, the results were: 69% excellent, 17% good, 7% fair, and 7% poor. Fair results occurred in three patients with associated symptoms of polyarthralgia who remained with residual pain. Three patients developed postoperative joint stiffness (7%).ConclusionThe procedure under study is safe and easy to reproduce. It shows high rates of positive results (86%). The opening made in the bursal side of the SS tendon allowed the arthroscope to remain in the subacromial space, making it easier to perform surgery.
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