Surgical Treatment for the Shoulder Joint in Rheumatoid Patients

Yoon,  Hyung Moon; Jo,  Young Hoon; Lee,  Bong Gun

doi:2016.19.3.179

Clin Shoulder Elb > Volume 19(3); 2016 > Article

Review

Clinics in Shoulder and Elbow 2016;19(3):179-185.
DOI: https://doi.org/10.5397/cise.2016.19.3.179 Published online September 30, 2016.

Surgical Treatment for the Shoulder Joint in Rheumatoid Patients

Hyung Moon Yoon, Young Hoon Jo, Bong Gun Lee

¹Department of Orthopaedic Surgery, Seoul Red Cross Hospital, Seoul, Korea.
²Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Korea. orthdr@naver.com

Received: 2 June 2016 • Revised: 8 August 2016 • Accepted: 8 August 2016

Abstract

Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.

Key Words: Rheumatoid arthritis; Shoulder; Arthroplasty; Reverse shoulder arthroplasty