Issue: December 2012
August 29, 2012
2 min read
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Reverse shoulder arthroplasty improves damage caused by inflammatory arthritis

Issue: December 2012
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Early reverse shoulder arthroplasty can provide improvement for patients with inflammatory arthritis of the shoulder and a deficient rotator cuff, according to this study.

Perspective from Peter J. Millett, MD, MSc

Researchers performed a retrospective review of 19 shoulders with rheumatoid or other inflammatory arthritis treated with reverse shoulder arthroplasty (RSA). Mean follow-up was 37 months. Researchers found a mean postoperative Visual Analog Pain scale score (VAPS) of 6.5 in patients and an average flexion of 68°, abduction of 66° and external rotation of 23°. VAPS decreased to one postoperatively, and there was an increase in flexion (138°), abduction (134°) and external rotation (52°). Mean American Shoulder and Elbow Society scores increased from 27 preoperatively to 76 postoperatively, and Simple Shoulder Test scores from one to eight.

There were 12 excellent, five satisfactory and two unsatisfactory results. Complications included two scapular spine fractures, one acromial fracture, one dislocation and one ulnar neuropathy. The investigators found that 42% of shoulders had scapular notching; six shoulders with grade 1 notching and two shoulders with grade 2 notching. Researchers found no evidence of glenoid loosening.

“The RSA provides encouraging early results for the rheumatoid patient. The presence of any complications is also a source of concern. However, we believe these complications are balanced by the typical substantial improvement of pain and function from RSA in these patients. We continue cautiously to recommend this procedure to our patients,” the researchers wrote in the study.