Effects of shoulder arthroplasty and exercise in patients with rheumatoid arthritis

The aim of this study was to examine pain and shoulder function in patients with rheumatoid arthritis (RA) before and after shoulder arthroplasty and postoperative exercise. Twenty-four patients (26 shoulders) were consecutively included in a multicentre study. Before surgery, at discharge from hospital and after 3 and 6 months, perceived shoulder function and shoulder pain were assessed by visual analogue scales, activities of daily living by the Modified Health Assessment Questionnaire (M-HAQ) and shoulder range of motion (ROM) by a goniometer. All patients showed considerable pain reduction at discharge from hospital (p<0.001). In those with intact rotator cuff and biceps tendon (n=13) improvements were found after 6 months in active and passive abduction and flexion ROMs (p<0.01) and in M-HAQ (p<0.001). Such improvements were not found in those with torn soft tissue (n=12). Preoperatively, abduction and flexion motor deficits (passive ROM >active ROM) were found for the total group (p=0.001). Less flexion motor deficit was found in the intact soft tissue than in the torn soft tissue group after 3 (p=0.002) and 6 months (p<0.001). No group difference was found with respect to abduction motor deficit. In conclusion, pain relief was obtained by all patients. Improvements in ROMs and activities of daily living were influenced by the state of the soft tissue.