Early results of reverse shoulder arthroplasty in patients with rheumatoid arthritis
Rheumatoid arthritis affecting the shoulder is typically associated with rotator cuff compromise and can also result in severe glenoid erosion. Since reverse shoulder arthroplasty is capable of addressing both rotator cuff disorders and glenoid bone deficiencies, our aim was to evaluate the outcome...
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Published in | Journal of bone and joint surgery. American volume Vol. 93; no. 20; p. 1915 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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United States
19.10.2011
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Abstract | Rheumatoid arthritis affecting the shoulder is typically associated with rotator cuff compromise and can also result in severe glenoid erosion. Since reverse shoulder arthroplasty is capable of addressing both rotator cuff disorders and glenoid bone deficiencies, our aim was to evaluate the outcome of reverse shoulder arthroplasty in patients with rheumatoid arthritis and either or both of these associated conditions.
We performed eighteen primary reverse total shoulder arthroplasties in sixteen patients with rheumatoid arthritis involving the shoulder as well as associated rotator cuff compromise and/or severe erosion of the glenoid bone between 2002 and 2007. Patients were assessed with use of the Constant score, patient satisfaction score, subjective shoulder value, range of shoulder motion, and imaging studies.
The mean Constant score improved from 22.5 to 64.9 points at a mean of 3.8 years (range, 2.1 to 7.0 years) postoperatively. The patients were either very satisfied or satisfied with the outcome of the surgery in seventeen of the eighteen shoulders. The mean subjective shoulder value was 68.6% postoperatively. Active forward elevation improved from 77.5° to 138.6°, and external rotation with the arm in 90° of abduction improved from 16.9° to 46.1°. The mean Constant score improved from 28.0 points to 74.3 points in shoulders in which the teres minor muscle was normal before the surgery, and it improved from 20.8 to 54.6 points in shoulders with an atrophic teres minor muscle. Scapular notching was observed in ten of the eighteen shoulders. A fracture involving the acromion, acromial spine, coracoid, or greater tuberosity was observed either intraoperatively or postoperatively in four of the eighteen shoulders. One case of transient axillary nerve injury was noted. There were no cases of dislocation, infection, or component loosening. None of the patients required revision surgery for any reason.
Comparatively good outcomes were observed in the short to intermediate term after reverse shoulder arthroplasty in patients with rheumatoid arthritis. However, surgeons should be aware of the risk of intraoperative and postoperative fractures in this patient group. |
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AbstractList | Rheumatoid arthritis affecting the shoulder is typically associated with rotator cuff compromise and can also result in severe glenoid erosion. Since reverse shoulder arthroplasty is capable of addressing both rotator cuff disorders and glenoid bone deficiencies, our aim was to evaluate the outcome of reverse shoulder arthroplasty in patients with rheumatoid arthritis and either or both of these associated conditions.
We performed eighteen primary reverse total shoulder arthroplasties in sixteen patients with rheumatoid arthritis involving the shoulder as well as associated rotator cuff compromise and/or severe erosion of the glenoid bone between 2002 and 2007. Patients were assessed with use of the Constant score, patient satisfaction score, subjective shoulder value, range of shoulder motion, and imaging studies.
The mean Constant score improved from 22.5 to 64.9 points at a mean of 3.8 years (range, 2.1 to 7.0 years) postoperatively. The patients were either very satisfied or satisfied with the outcome of the surgery in seventeen of the eighteen shoulders. The mean subjective shoulder value was 68.6% postoperatively. Active forward elevation improved from 77.5° to 138.6°, and external rotation with the arm in 90° of abduction improved from 16.9° to 46.1°. The mean Constant score improved from 28.0 points to 74.3 points in shoulders in which the teres minor muscle was normal before the surgery, and it improved from 20.8 to 54.6 points in shoulders with an atrophic teres minor muscle. Scapular notching was observed in ten of the eighteen shoulders. A fracture involving the acromion, acromial spine, coracoid, or greater tuberosity was observed either intraoperatively or postoperatively in four of the eighteen shoulders. One case of transient axillary nerve injury was noted. There were no cases of dislocation, infection, or component loosening. None of the patients required revision surgery for any reason.
Comparatively good outcomes were observed in the short to intermediate term after reverse shoulder arthroplasty in patients with rheumatoid arthritis. However, surgeons should be aware of the risk of intraoperative and postoperative fractures in this patient group. |
Author | Walch, Gilles Moraga, Claudio Smith, Margaret M Bacle, Guillaume Young, Allan A |
Author_xml | – sequence: 1 givenname: Allan A surname: Young fullname: Young, Allan A organization: Centre Orthopédique Santy, Lyon, France – sequence: 2 givenname: Margaret M surname: Smith fullname: Smith, Margaret M – sequence: 3 givenname: Guillaume surname: Bacle fullname: Bacle, Guillaume – sequence: 4 givenname: Claudio surname: Moraga fullname: Moraga, Claudio – sequence: 5 givenname: Gilles surname: Walch fullname: Walch, Gilles |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22012529$$D View this record in MEDLINE/PubMed |
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Snippet | Rheumatoid arthritis affecting the shoulder is typically associated with rotator cuff compromise and can also result in severe glenoid erosion. Since reverse... |
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SubjectTerms | Aged Arthritis, Rheumatoid - diagnosis Arthritis, Rheumatoid - surgery Arthroplasty, Replacement - methods Cohort Studies Female Follow-Up Studies Humans Joint Prosthesis Male Middle Aged Pain Measurement Patient Satisfaction Postoperative Care - methods Radiography Range of Motion, Articular - physiology Retrospective Studies Severity of Illness Index Shoulder Joint - diagnostic imaging Shoulder Joint - surgery Shoulder Pain - diagnosis Shoulder Pain - etiology Statistics, Nonparametric Time Factors Treatment Outcome |
Title | Early results of reverse shoulder arthroplasty in patients with rheumatoid arthritis |
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