| 摘要 |
<p>A subacromial spacer (10) is provided as a device for treating a shoulder with a severe or irreparable lesion of the rotator cuff, by keeping a predetermined distance between an acromion and a corresponding humeral head. The subacromial spacer (10) has an articulating surface (11) whose radius of curvature (R) is longer than the radius of curvature of the humeral head of any possible patient, in particular radius (R) is longer than 60 mm, such that articulating surface (11) of subacromial spacer (10) and humeral head (52) reciprocally engage in a substantially punctiform contact, and humeral head (52) and articulating surface (11) roll without sliding with respect to each other. This way, a low friction arrangement is obtained, which drastically reduces articulation wear, i.e. the patient's healthy humeral head wear. The subacromial spacer according to the invention is therefore particularly suitable for treating those patients whose humeral head is not substantially compromised. In a preferred embodiment, a toolkit for implanting subacromial spacer (10) into the subacromial location 1 through a front transdeltoid approach comprises a clamp, and a means for fixing subacromial spacer (10) to acromion (51) comprising a plurality of anchor blades (13). Subacromial spacer (10) is pressed against acromion (51) such that anchor blades (13) penetrates the lower surface (53) of the acromion (51), optionally by deepening respective incisions that are previously made upon the lower surface (53) of the acromion (51). The compression can be obtained by tightening a screw (15), which extends along through hole (55) previously made within the acromion and engages a screw threaded hole 14 of the subacromial spacer (10). The compression may also be obtained by means of a hand press that is constrained to the clamp and has a plate-like pressing element that in use is arranged above the shoulder. The anchor blades (13) may also have transversal through holes (17), which allow bone growth and subsequent joining of bone edges of incisions (54), to provide a secondary stabilization step of subacromial spacer (10).</p> |
