Shoulder arthroplasty for rheumatoid arthritis

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Biomedical Engineering

Background:

• Rheumatoid arthritis frequently affects the shoulder joint, leading to pain and functional limitations.
• Total shoulder arthroplasty is a surgical option for managing severe shoulder joint destruction in rheumatoid arthritis.

Purpose of the Study:

• To evaluate the clinical outcomes of the Designed After Natural Anatomy (DANA) total shoulder arthroplasty in rheumatoid arthritis patients.
• To assess the impact of rotator cuff integrity on functional outcomes and range of motion after DANA total shoulder arthroplasty.

Main Methods:

• A retrospective review of 42 DANA total shoulder arthroplasties in 34 rheumatoid arthritis patients.
• Follow-up of 30 shoulders in 23 patients for a minimum of two years, assessing pain, function, and range of motion.
• Analysis of rotator cuff integrity and the use of different glenoid component designs (regular vs. hooded).

Main Results:

• Significant improvements in average pain scores (3 to 8) and function scores (3 to 6) were observed postoperatively.
• Substantial improvement in range of motion was noted in patients with intact rotator cuffs treated with regular glenoid components.
• In rotator-cuff-deficient patients, pain and function improved, but range of motion remained unchanged.
• Complications included acromial fracture and glenoid component loosening, necessitating revision surgery.

Conclusions:

• DANA total shoulder arthroplasty provides significant pain relief and functional improvement for rheumatoid arthritis patients.
• Rotator cuff status is a critical factor influencing range of motion outcomes after DANA total shoulder arthroplasty.
• While hooded glenoid components may offer stability in rotator-cuff-deficient shoulders, they did not enhance range of motion in this cohort.