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Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report

INTRODUCTION: Dysbaric osteonecrosis (DON) is a specific type of atraumatic osteonecrosis that has been shown to occur mainly in deep-sea divers and workers exposed to increased air pressure environments. The pathophysiology is not entirely understood but is thought to be due to subclinical decompre...

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Autores principales: Cárdenas, Gabriel, Gasbarro, Gregory, Aceituno, Gianella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009484/
https://www.ncbi.nlm.nih.gov/pubmed/35437500
http://dx.doi.org/10.13107/jocr.2021.v11.i06.2278
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author Cárdenas, Gabriel
Gasbarro, Gregory
Aceituno, Gianella
author_facet Cárdenas, Gabriel
Gasbarro, Gregory
Aceituno, Gianella
author_sort Cárdenas, Gabriel
collection PubMed
description INTRODUCTION: Dysbaric osteonecrosis (DON) is a specific type of atraumatic osteonecrosis that has been shown to occur mainly in deep-sea divers and workers exposed to increased air pressure environments. The pathophysiology is not entirely understood but is thought to be due to subclinical decompression sickness resulting in arterial gas emboli. This leads to vascular occlusion and subsequent bone death. CASE REPORT: An active 56-year-old male diver presented with progressive bilateral shoulder pain and dysfunction due to bilateral DON of the humeral head and associated posterosuperior rotator cuff tearing. The diagnosis was confirmed by physical examination, X-rays, and magnetic resonance imaging. Due to failure of conservative treatment, a single-stage bilateral, subscapularis-sparing, stemless shoulder hemiarthroplasty with concomitant rotator cuff repair was performed. At 24-month follow-up, the patient showed satisfactory functional outcomes in both shoulders without complication. CONCLUSION: This single-stage surgical treatment is an exceptional indication for a bilateral dysbaric humeral head osteonecrosis that can be considered in selected cases because may reduce the total recovery time and can be safe and effective at 24 months postoperatively.
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spelling pubmed-90094842022-04-17 Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report Cárdenas, Gabriel Gasbarro, Gregory Aceituno, Gianella J Orthop Case Rep Case Report INTRODUCTION: Dysbaric osteonecrosis (DON) is a specific type of atraumatic osteonecrosis that has been shown to occur mainly in deep-sea divers and workers exposed to increased air pressure environments. The pathophysiology is not entirely understood but is thought to be due to subclinical decompression sickness resulting in arterial gas emboli. This leads to vascular occlusion and subsequent bone death. CASE REPORT: An active 56-year-old male diver presented with progressive bilateral shoulder pain and dysfunction due to bilateral DON of the humeral head and associated posterosuperior rotator cuff tearing. The diagnosis was confirmed by physical examination, X-rays, and magnetic resonance imaging. Due to failure of conservative treatment, a single-stage bilateral, subscapularis-sparing, stemless shoulder hemiarthroplasty with concomitant rotator cuff repair was performed. At 24-month follow-up, the patient showed satisfactory functional outcomes in both shoulders without complication. CONCLUSION: This single-stage surgical treatment is an exceptional indication for a bilateral dysbaric humeral head osteonecrosis that can be considered in selected cases because may reduce the total recovery time and can be safe and effective at 24 months postoperatively. Indian Orthopaedic Research Group 2021-06 /pmc/articles/PMC9009484/ /pubmed/35437500 http://dx.doi.org/10.13107/jocr.2021.v11.i06.2278 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Cárdenas, Gabriel
Gasbarro, Gregory
Aceituno, Gianella
Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report
title Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report
title_full Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report
title_fullStr Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report
title_full_unstemmed Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report
title_short Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report
title_sort single-stage bilateral stemless shoulder hemiarthroplasty using a subscapularis-sparing approach for bilateral dysbaric osteonecrosis of the humeral head in a diver: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009484/
https://www.ncbi.nlm.nih.gov/pubmed/35437500
http://dx.doi.org/10.13107/jocr.2021.v11.i06.2278
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