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- Syringomyelia
- Occurs in 25% of patients with syringomyelia; 75% of Charcot shoulder is syringomyelia
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- XR shoulder
- MRI Cervical spine!
- Joint aspiration TRO infection
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- Ensure NES review and decompression of syrinx cavity to prevent deterioration before surgical treatment
- Arthrodesis
- Historically treatment of choice but recent studies show poor outcomes
- Arthroplasty
- Previously contraindicated in neuropathic joints but now used in disparate conditions
- Hemiarthroplasty + RC repair
- Case series by Matsuhashi et al. JSES 2011. 8 year follow up for 3 patients with syringomyelia. No dislocations with improvement in ROM
- RTSA
- Case report by Ueblacker et al. in JSES 2006 of bilateral RTSA for severe syringomelia and demonstrated survival at 26 and 30 months. Giving a marked improvement in ROM
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- Arthrodesis is mainstay
- James Tan et al. Shoulder and Elbow 2015. Case report of neuropathic arthropathy fused with double Posterior. + medial plate and bone grafting in a domestic helper.
- Resection Arthroplasty
- Kwon and Morrey et al. JSES 2006. Case series of 4 resection arthroplasty. 3 has gross instability but with good functional use of elbow.
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- 30/30/30
- Flexion 30, abduction 30, IR 30