Open surgical treatment for dialysis-related arthropathy in the shoulder

The clinical results of open surgical treatment fbr hemodialysis-related ar thropathy in the shoulder were evaluated and the pathology was investigated Fifteen shoulders of 11 patients (6 female and 5 male) were treated during the post 6 years. The average age was 56.7 years. The duration of hemodial ysis averaged 17.5 years. Simple curettage was performed in 7 shoulders, an d curettage and bone graft were performed in 5 shoulders. Repair of the rot ator cuff was performed in 3 shoulders. Pathologic foci always existed in t he intertubercular sulcus and the greater tuberosity of the humerus. Marked proliferations of the bursa and multiple cystic bone lesions were found, a nd amyloid depositions were observed on histologic evaluation in all cases. Open surgical treatment was quite effective, and relief from the clinical symptoms was maintained For a satisfactory period of time. Enthesopathy ind uced by the amyloid deposition is considered the main pathology.