Hemiarthroplasty for charcot shoulder arthropathy secondary to syringomyelia: a case report and literature review

Background Syringomyelia complicated by Charcot shoulder arthropathy is a severely debilitating neuropathic joint disorder. The core pathology involves dual impairment of pain-temperature sensation and sympathetic fibers due to the syrinx, leading the glenohumeral joint to endure abnormal mechanical stress without neuroprotective feedback, resulting in progressive osseous and articular destruction. However, due to the rarity of this condition, its management remains highly controversial. This article reports a case of hemiarthroplasty for Charcot shoulder arthropathy caused by syringomyelia and reviews the relevant literature for reference. Case Presentation A 50-year-old female patient presented to our hospital with a 6-year history of right shoulder pain and restricted mobility. Examinations confirmed syringomyelia with concomitant right-sided Charcot shoulder arthropathy and glenohumeral dislocation. The patient underwent hemiarthroplasty of the humeral head combined with rotator cuff repair to address the joint pathology. The management of the syringomyelia and associated Chiari malformation was planned for a second-stage surgery. At the one-month postoperative follow-up, numbness on the dorsum of the right hand had significantly decreased, the range of motion (ROM) of the right shoulder had markedly improved, and the shoulder Constant-Murley score was 80. Conclusion Prioritizing joint arthroplasty to address secondary Charcot arthropathy for pain relief and functional improvement, followed by elective surgery for the primary neurological disorder, may be a more suitable strategy for patients with syringomyelia and end-stage Charcot shoulder arthropathy. Multidisciplinary collaboration and long-term follow-up are essential for optimizing surgical strategies and improving long-term outcomes in these patients.