B25期临床型硕士研究生专业英语考试2.doc

窗体顶部 临床型硕士研究生专业英语考试题 Meniscal Allograft 半月板同种异体移植物Interposition Arthroplasty插入关节成形术 for the Arthritic Shoulder肩关节炎: Description描述 of a New Surgical Technique INTRODUCTION The younger patient with advanced arthritis of the glenohumeral joint presents a difficult treatment problem, particularly when there are structural changes involving the glenoid. Severe pain and restriction of motion can occur that often is refractory to nonoperative measures. Treatment options for these patients have included arthroscopic debridement, glenoidplasty, arthrodesis, and prosthetic replacement of the joint. Total joint arthroplasty probably results in the best functional outcome and can provide predictable pain relief, but concerns about wear and loosening over the glenoid component mean that it is an option in only select cases. Humeral head replacement alone traditionally has been the most common reconstructive procedure performed for this patient group. Pain usually is lessened, but the results have been less favorable in terms of range of motion and strength, especially when there is asymmetric wear or damage to the glenoid (1–4). Long-term follow-up studies of patients treated with hemiarthroplasty have shown that progressive glenoid erosion may occur, which can result in increasing pain (5,6). In an attempt to improve the functional results and pain relief in younger patients with severe glenohumeral arthritis and glenoid involvement, we have developed a new technique that involves hemiarthroplasty combined with resurfacing of the glenoid using a meniscal allograft. The aim is to provide a new biologic articulating surface for the humeral head prosthesis in the form of an interposition arthroplasty. HISTORICAL PERSPECTIVE The concept of interposition arthroplasty is not new. The earliest description in the United States was by Murphy (7) in 1904, reporting on the use of fascia lata in the knee. The elbow has been a common site for interposition arthroplasty, with numerous report