Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Surgical Treatment for the Shoulder Joint in Rheumatoid Patients

  • Yoon, Hyung Moon (Department of Orthopaedic Surgery, Seoul Red Cross Hospital) ;
  • Jo, Young-Hoon (Department of Orthopaedic Surgery, Hanyang University College of Medicine) ;
  • Lee, Bong Gun (Department of Orthopaedic Surgery, Hanyang University College of Medicine)
  • Received : 2016.06.02
  • Accepted : 2016.08.08
  • Published : 2016.09.30
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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.

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References

  1. Cuomo F, Greller MJ, Zuckerman JD. The rheumatoid shoulder. Rheum Dis Clin North Am. 1998;24(1):67-82. https://doi.org/10.1016/S0889-857X(05)70378-1
  2. Petersson CJ. Painful shoulders in patients with rheumatoid arthritis. Prevalence, clinical and radiological features. Scand J Rheumatol. 1986;15(3):275-9. https://doi.org/10.3109/03009748609092592
  3. McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365(23):2205-19. https://doi.org/10.1056/NEJMra1004965
  4. Furst DE, Emery P. Rheumatoid arthritis pathophysiology: update on emerging cytokine and cytokine-associated cell targets. Rheumatology (Oxford). 2014;53(9):1560-9. https://doi.org/10.1093/rheumatology/ket414
  5. Burmester GR, Kivitz AJ, Kupper H, et al. Efficacy and safety of ascending methotrexate dose in combination with adalimumab: the randomised CONCERTO trial. Ann Rheum Dis. 2015;74(6):1037-44. https://doi.org/10.1136/annrheumdis-2013-204769
  6. Rhee DK, Marcelino J, Baker M, et al. The secreted glycoprotein lubricin protects cartilage surfaces and inhibits synovial cell overgrowth. J Clin Invest. 2005;115(3):622-31. https://doi.org/10.1172/JCI200522263
  7. Sabeh F, Fox D, Weiss SJ. Membrane-type I matrix metalloproteinase-dependent regulation of rheumatoid arthritis synoviocyte function. J Immunol. 2010;184(11):6396-406. https://doi.org/10.4049/jimmunol.0904068
  8. van der Heijde DM. Joint erosions and patients with early rheumatoid arthritis. Br J Rheumatol. 1995;34 Suppl 2:74-8.
  9. Gravallese EM, Harada Y, Wang JT, Gorn AH, Thornhill TS, Goldring SR. Identification of cell types responsible for bone resorption in rheumatoid arthritis and juvenile rheumatoid arthritis. Am J Pathol. 1998;152(4):943-51.
  10. Schett G, Teitelbaum SL. Osteoclasts and arthritis. J Bone Miner Res. 2009;24(7):1142-6. https://doi.org/10.1359/jbmr.090533
  11. Jimenez-Boj E, Redlich K, Turk B, et al. Interaction between synovial inflammatory tissue and bone marrow in rheumatoid arthritis. J Immunol. 2005;175(4):2579-88. https://doi.org/10.4049/jimmunol.175.4.2579
  12. Chen AL, Joseph TN, Zuckerman JD. Rheumatoid arthritis of the shoulder. J Am Acad Orthop Surg. 2003;11(1):12-24. https://doi.org/10.5435/00124635-200301000-00004
  13. Rozing PM, Brand R. Rotator cuff repair during shoulder arthroplasty in rheumatoid arthritis. J Arthroplasty. 1998;13(3):311-9. https://doi.org/10.1016/S0883-5403(98)90177-2
  14. Friedman RJ, Thornhill TS, Thomas WH, Sledge CB. Non-constrained total shoulder replacement in patients who have rheumatoid arthritis and class-IV function. J Bone Joint Surg Am. 1989;71(4):494-8. https://doi.org/10.2106/00004623-198971040-00003
  15. Cruess RL. Rheumatoid arthritis of the shoulder. Orthop Clin North Am. 1980;11(2):333-42.
  16. Tan YK, Conaghan PG. Imaging in rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2011;25(4):569-84. https://doi.org/10.1016/j.berh.2011.10.002
  17. Wakefield RJ Balint PV, Szkudlarek M, et al. Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol. 2005;32(12):2485-7.
  18. Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh). 1977;18(4):481-91. https://doi.org/10.1177/028418517701800415
  19. Levigne C. Radiographic classifications and evolutions of the rheumatoid shoulder [in French]. Rev Rhum (Ed Fr). 2002; 69(Suppl 3):108-12.
  20. Levigne C, Franceschi J. Rheumatoid arthritis of the shoulder: radiological presentation and results of arthroplasty. In: Walch G, Boileau P, eds. Shoulder arthroplasty. Berlin Heidelberg New York: Springer; 1999. 221-30.
  21. Young AA, Smith MM, Bacle G, Moraga C, Walch G. Early results of reverse shoulder arthroplasty in patients with rheumatoid arthritis. J Bone Joint Surg Am. 2011;93(20):1915-23. https://doi.org/10.2106/JBJS.J.00300
  22. Ekelund A, Nyberg R. Can reverse shoulder arthroplasty be used with few complications in rheumatoid arthritis? Clin Orthop Relat Res. 2011;469(9):2483-8. https://doi.org/10.1007/s11999-010-1654-4
  23. Nakamura H, Nagashima M, Ishigami S, Wauke K, Yoshino S. The anti-rheumatic effect of multiple synovectomy in patients with refractory rheumatoid arthritis. Int Orthop. 2000;24(5): 242-5. https://doi.org/10.1007/s002640000168
  24. Ossyssek B, Anders S, Grifka J, Straub RH. Surgical synovectomy decreases density of sensory nerve fibers in synovial tissue of non-inflamed controls and rheumatoid arthritis patients. J Orthop Res. 2011;29(2):297-302. https://doi.org/10.1002/jor.21233
  25. Pahle JA, Kvarnes L. Shoulder synovectomy. Ann Chir Gynaecol Suppl. 1985;198:37-9.
  26. Petersson CJ. Shoulder surgery in rheumatoid arthritis. Acta Orthop Scand. 1986;57(3):222-6. https://doi.org/10.3109/17453678608994381
  27. Smith AM, Sperling JW, O'Driscoll SW, Cofield RH. Arthroscopic shoulder synovectomy in patients with rheumatoid arthritis. Arthroscopy. 2006;22(1):50-6. https://doi.org/10.1016/j.arthro.2005.10.011
  28. Kanbe K, Chiba J, Inoue Y, Taguchi M, Iwamatsu A. Analysis of clinical factors related to the efficacy of shoulder arthroscopic synovectomy plus capsular release in patients with rheumatoid arthritis. Eur J Orthop Surg Traumatol. 2015;25(3):451-5. https://doi.org/10.1007/s00590-014-1570-5
  29. Wakitani S, Imoto K, Saito M, et al. Evaluation of surgeries for rheumatoid shoulder based on the destruction pattern. J Rheumatol. 1999;26(1):41-6.
  30. Magermans DJ, Smits NC, Chadwick EK, Veeger D, van der Helm FC, Rozing PM. Discriminating factors for functional outcome after shoulder arthroplasty. A critical review of the literature. Acta Orthop Belg. 2003;69(2):127-36.
  31. Stewart MP, Kelly IG. Total shoulder replacement in rheumatoid disease: 7-to 13-year follow-up of 37 joints. J Bone Joint Surg Br. 1997;79(1):68-72. https://doi.org/10.1302/0301-620X.79B1.6645
  32. Sneppen O, Fruensgaard S, Johannsen HV, Olsen BS, Sojbjerg JO, Andersen NH. Total shoulder replacement in rheumatoid arthritis: proximal migration and loosening. J Shoulder Elbow Surg. 1996;5(1):47-52. https://doi.org/10.1016/S1058-2746(96)80030-9
  33. Pollock RG, Deliz ED, McIlveen SJ, Flatow EL, Bigliani LU. Prosthetic replacement in rotator cuff-deficient shoulders. J Shoulder Elbow Surg. 1992;1(4):173-86. https://doi.org/10.1016/1058-2746(92)90011-Q
  34. Boyd AD Jr, Thomas WH, Scott RD, Sledge CB, Thornhill TS. Total shoulder arthroplasty versus hemiarthroplasty. Indications for glenoid resurfacing. J Arthroplasty. 1990;5(4):329-36. https://doi.org/10.1016/S0883-5403(08)80092-7
  35. Sperling JW, Cofield RH, Schleck CD, Harmsen WS. Total shoulder arthroplasty versus hemiarthroplasty for rheumatoid arthritis of the shoulder: results of 303 consecutive cases. J Shoulder Elbow Surg. 2007;16(6):683-90. https://doi.org/10.1016/j.jse.2007.02.135
  36. Trail IA, Nuttall D. The results of shoulder arthroplasty in patients with rheumatoid arthritis. J Bone Joint Surg Br. 2002;84(8):1121-5. https://doi.org/10.1302/0301-620X.84B8.12695
  37. Kelly IG, Foster RS, Fisher WD. Neer total shoulder replacement in rheumatoid arthritis. J Bone Joint Surg Br. 1987;69(5):723-6.
  38. Betts HM, Abu-Rajab R, Nunn T, Brooksbank AJ. Total shoulder replacement in rheumatoid disease: a 16-to 23-year followup. J Bone Joint Surg Br. 2009;91(9):1197-200.
  39. Rahme H, Mattsson P, Wikblad L, Larsson S. Cement and press-fit humeral stem fixation provides similar results in rheumatoid patients. Clin Orthop Relat Res. 2006;448:28-32. https://doi.org/10.1097/01.blo.0000224007.25636.85
  40. Berliner JL, Regalado-Magdos A, Ma CB, Feeley BT. Biomechanics of reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2015;24(1):150-60. https://doi.org/10.1016/j.jse.2014.08.003
  41. Gee EC, Hanson EK, Saithna A. Reverse shoulder arthroplasty in rheumatoid arthritis: a systematic review. Open Orthop J. 2015;9:237-45. https://doi.org/10.2174/1874325001509010237
  42. Simovitch RW, Zumstein MA, Lohri E, Helmy N, Gerber C. Predictors of scapular notching in patients managed with the Delta III reverse total shoulder replacement. J Bone Joint Surg Am. 2007;89(3):588-600. https://doi.org/10.2106/JBJS.F.00226