Resection arthroplasty of the shoulder

Destruction of the gleno-humeral joint is a well-known and common feature of progressive rheumatoid arthritis. The most striking symptoms are pain and limited motion. Very occasionally spontaneous ankylosis occurs. The impact often relegates the patient to the second and third functional class according to the ARA classification system. The most commonly used surgical methods are endoprosthetic arthroplasty, double osteotomy and early and late synovectomy. Resection interpositioning arthroplasty (RIAP) of the rheumatic elbow joint using lyophilized dura mater has shown excellent results. This encouraged us to apply the same surgical principles to the shoulder joint in rheumatoid arthritis and this report presents the surgical procedure and the primary results of our first 13 patients. Very good results were achieved concerning immediate pain relief and mobility gain, while the muscle strength improved significantly after approximately one year. The surgical technique is fairly simple and postoperative exercises are preferably performed with the help of relatives.