Abstract | BACKGROUND: This is an update on a previously documented cohort of patients who underwent shoulder arthroplasty for rheumatoid arthritis, with a minimum 5-year clinical follow-up. METHODS: RESULTS: Kaplan-Meier survivorship free of revision at 5 years and 10 years was 96.1% and 92.9% for total shoulder arthroplasty ( TSA) and 89.2% and 87.9% for hemiarthroplasty (HA). The most common indications were glenoid loosening (5%) and infection (2%) for TSA revision and glenoid arthrosis (7%) for HA revision. Pain relief was greater with TSA than with HA. In patients with an intact rotator cuff, in comparing TSA with HA, those with a TSA had greater improvements in pain scores (-2.7 vs. -1.8 on a 5-point scale) and degrees of elevation (45 versus 24) (P = .08). Approximately 30% of humeral components and 73% of glenoid components had periprosthetic lucencies. There was a shift in position of the glenoid in 33% of TSAs, and 36% were "at risk." Eighty-one percent of HAs had moderate or severe glenoid erosion. DISCUSSION/CONCLUSION: Both HA and TSA provide pain relief and improved motion in patients with rheumatoid arthritis. In patients with an intact rotator cuff, pain relief and range of motion are more improved with TSA compared with HA. There is a high rate of component lucency, but component revision is uncommon. LEVEL OF EVIDENCE: Level IV, case series, treatment study.
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Authors | Jonathan D Barlow, Brandon J Yuan, Cathy D Schleck, W Scott Harmsen, Robert H Cofield, John W Sperling |
Journal | Journal of shoulder and elbow surgery
(J Shoulder Elbow Surg)
Vol. 23
Issue 6
Pg. 791-9
(Jun 2014)
ISSN: 1532-6500 [Electronic] United States |
PMID | 24315477
(Publication Type: Journal Article)
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Copyright | Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved. |
Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Arthritis, Rheumatoid
(diagnostic imaging, surgery)
- Arthroplasty, Replacement
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Radiography
- Range of Motion, Articular
- Retrospective Studies
- Rotator Cuff
(surgery)
- Shoulder Joint
(diagnostic imaging, surgery)
- Treatment Outcome
- Young Adult
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