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Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: Early Outcomes, Pitfalls, and Challenges
Objective To evaluate the early outcomes and risk factors of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA). Methods A retrospective study was performed on RA patients who had undergone RSA between January 2016 and January 2018. Preoperative glenohumeral joint damage...
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| Published in: | Orthopaedic surgery 2020-10, Vol.12 (5), p.1380-1387 |
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| creator | He, Yong Xiao, Lian‐bo Zhai, Wei‐tao Xu, Yue‐lin |
| description | Objective
To evaluate the early outcomes and risk factors of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA).
Methods
A retrospective study was performed on RA patients who had undergone RSA between January 2016 and January 2018. Preoperative glenohumeral joint damage was evaluated according to two radiographic classification systems. The severity of joint damage was estimated using Larsen's method, while the Levigne‐Franceschi method was used to assess the type of destruction. Further, we recorded intra‐ and postoperative complications. Visual Analogue Scale (VAS) was used to assess the degree of shoulder pain while shoulder function was evaluated with the American Shoulder and Elbow Surgeons (ASES) Shoulder Score. In addition, patients' subjective outcome and range of shoulder motion were recorded. Radiographs were taken and examined during the follow‐up period. Paired t‐test was used to determine the difference in measurement data between preoperative and the last follow‐up. VAS was analyzed using the Wilcoxon matched‐pairs signed‐rank test.
Results
A total of 14 patients with 14 shoulders were included. All the patients were female with an average age of 60.29 years (range, 49–71 years) at the time of surgery and an average RA disease duration of 24.57 years (range, 5–40 years). Seven of the 14 patients had a history of joint surgery related to RA. Meanwhile, 11 of the 14 shoulders showed glenoid bone defect, and eccentric reaming was performed intraoperatively to avoid base plate malposition. The mean follow‐up period for the 14 patients was 2.76 years (range, 2–4 years). The mean VAS decreased from a value of 5.71 ± 1.10 preoperatively to 1.36 ± 0.61 postoperatively (P |
| doi_str_mv | 10.1111/os.12769 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_d58710befa154059b7ff405b0869d674</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_d58710befa154059b7ff405b0869d674</doaj_id><sourcerecordid>2460938062</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4819-a44770998ca1d5da26751fea24d2e3baddb509734a91511b5975db32ba2199113</originalsourceid><addsrcrecordid>eNp1kU1r3DAQhkVpaT5a6E8Q9NJDnGpsy7J6KIQlTQKBDfk4i7Elr7XY1laSE_bfV41DIIfoMi-jh2eQhpBvwE4hnZ8unEIuKvmBHILgIhN1BR9fMy8OyFEIW8YqWQjxmRwUec0KCfUhGW_No_HB0LvezYM2np752Hu3GzDEPbUTvcFozRQDfbKxp7e9mUeMzuoFtNGGX_Qc_bCn6zm2bjThhN7Y2OEwpISTpqs-ZTNtTPhCPqV-MF9f6jF5-HN-v7rMrtcXV6uz66wta5AZlqUQTMq6RdBcY14JDp3BvNS5KRrUuuFMiqJECRyg4VJw3RR5gzlICVAck6vFqx1u1c7bEf1eObTqueH8RqGPth2M0rwWwBrTIfCScdmIrku1YXUldSXK5Pq9uHZzMxrdpr_wOLyRvr2ZbK827lGJSjDgLAm-vwi8-zubENXWzX5K71d5WTFZ1KzKE_VjoVrvQvCme50ATP1fsnJBPS85odmCPtnB7N_l1Ppu4f8Bf_am6A</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2460938062</pqid></control><display><type>article</type><title>Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: Early Outcomes, Pitfalls, and Challenges</title><source>Wiley-Blackwell Open Access Collection</source><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>He, Yong ; Xiao, Lian‐bo ; Zhai, Wei‐tao ; Xu, Yue‐lin</creator><creatorcontrib>He, Yong ; Xiao, Lian‐bo ; Zhai, Wei‐tao ; Xu, Yue‐lin</creatorcontrib><description>Objective
To evaluate the early outcomes and risk factors of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA).
Methods
A retrospective study was performed on RA patients who had undergone RSA between January 2016 and January 2018. Preoperative glenohumeral joint damage was evaluated according to two radiographic classification systems. The severity of joint damage was estimated using Larsen's method, while the Levigne‐Franceschi method was used to assess the type of destruction. Further, we recorded intra‐ and postoperative complications. Visual Analogue Scale (VAS) was used to assess the degree of shoulder pain while shoulder function was evaluated with the American Shoulder and Elbow Surgeons (ASES) Shoulder Score. In addition, patients' subjective outcome and range of shoulder motion were recorded. Radiographs were taken and examined during the follow‐up period. Paired t‐test was used to determine the difference in measurement data between preoperative and the last follow‐up. VAS was analyzed using the Wilcoxon matched‐pairs signed‐rank test.
Results
A total of 14 patients with 14 shoulders were included. All the patients were female with an average age of 60.29 years (range, 49–71 years) at the time of surgery and an average RA disease duration of 24.57 years (range, 5–40 years). Seven of the 14 patients had a history of joint surgery related to RA. Meanwhile, 11 of the 14 shoulders showed glenoid bone defect, and eccentric reaming was performed intraoperatively to avoid base plate malposition. The mean follow‐up period for the 14 patients was 2.76 years (range, 2–4 years). The mean VAS decreased from a value of 5.71 ± 1.10 preoperatively to 1.36 ± 0.61 postoperatively (P < 0.001). On the contrary, the ASES score showed an increase from 33.93 ± 6.89 to 76.67 ± 5.23 (P < 0.001). An increase in active forward elevation, abduction, and external rotation with the arm in 90° of abduction from 85.71° ± 17.61°, 77.14° ± 19.43°, and 17.14° ± 10.97° to 126.43° ± 5.23°, 106.42° ± 11.72°, and 38.57° ± 14.57°, respectively, was observed (P < 0.001). Subjective outcome assessment showed that 13 of the 14 patients were very satisfied or satisfied with the operation, while one patient was uncertain due to co‐existing ipsilateral elbow lesion. Notably, one patient acquired a humeral periprosthetic fracture during the operation. In this study, no major complications such as periprosthetic joint infection and dislocation or implant loosening were observed. Further, no patients underwent revision for any reason at the end of the follow‐up.
Conclusions
RSA could achieve good early outcomes without high complication rates in patients with RA. Glenoid bone defects and adjacent joints involvement were common in this patient group, which might increase the risk of surgery and affect postoperative satisfaction.
Reverse shoulder arthroplasty could achieve good early outcomes without high complication rates in patients with rheumatoid arthritis. Glenoid bone defects and adjacent joints involvement were common in this patient group, which might increase the risk of surgery and affect postoperative satisfaction.</description><identifier>ISSN: 1757-7853</identifier><identifier>EISSN: 1757-7861</identifier><identifier>DOI: 10.1111/os.12769</identifier><identifier>PMID: 32803918</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Classification ; Clinical ; Clinical outcomes ; Fractures ; Hospitals ; Joint replacement surgery ; Joint surgery ; Pain ; Patient satisfaction ; Reverse shoulder arthroplasty ; Rheumatoid arthritis ; Risk factor ; Rotator cuff ; Shoulder</subject><ispartof>Orthopaedic surgery, 2020-10, Vol.12 (5), p.1380-1387</ispartof><rights>2020 The Authors. published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.</rights><rights>2020. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4819-a44770998ca1d5da26751fea24d2e3baddb509734a91511b5975db32ba2199113</citedby><cites>FETCH-LOGICAL-c4819-a44770998ca1d5da26751fea24d2e3baddb509734a91511b5975db32ba2199113</cites><orcidid>0000-0002-8303-9570</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2460938062/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2460938062?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,11541,25731,27901,27902,36989,44566,46027,46451,53766,53768,74869</link.rule.ids></links><search><creatorcontrib>He, Yong</creatorcontrib><creatorcontrib>Xiao, Lian‐bo</creatorcontrib><creatorcontrib>Zhai, Wei‐tao</creatorcontrib><creatorcontrib>Xu, Yue‐lin</creatorcontrib><title>Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: Early Outcomes, Pitfalls, and Challenges</title><title>Orthopaedic surgery</title><description>Objective
To evaluate the early outcomes and risk factors of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA).
Methods
A retrospective study was performed on RA patients who had undergone RSA between January 2016 and January 2018. Preoperative glenohumeral joint damage was evaluated according to two radiographic classification systems. The severity of joint damage was estimated using Larsen's method, while the Levigne‐Franceschi method was used to assess the type of destruction. Further, we recorded intra‐ and postoperative complications. Visual Analogue Scale (VAS) was used to assess the degree of shoulder pain while shoulder function was evaluated with the American Shoulder and Elbow Surgeons (ASES) Shoulder Score. In addition, patients' subjective outcome and range of shoulder motion were recorded. Radiographs were taken and examined during the follow‐up period. Paired t‐test was used to determine the difference in measurement data between preoperative and the last follow‐up. VAS was analyzed using the Wilcoxon matched‐pairs signed‐rank test.
Results
A total of 14 patients with 14 shoulders were included. All the patients were female with an average age of 60.29 years (range, 49–71 years) at the time of surgery and an average RA disease duration of 24.57 years (range, 5–40 years). Seven of the 14 patients had a history of joint surgery related to RA. Meanwhile, 11 of the 14 shoulders showed glenoid bone defect, and eccentric reaming was performed intraoperatively to avoid base plate malposition. The mean follow‐up period for the 14 patients was 2.76 years (range, 2–4 years). The mean VAS decreased from a value of 5.71 ± 1.10 preoperatively to 1.36 ± 0.61 postoperatively (P < 0.001). On the contrary, the ASES score showed an increase from 33.93 ± 6.89 to 76.67 ± 5.23 (P < 0.001). An increase in active forward elevation, abduction, and external rotation with the arm in 90° of abduction from 85.71° ± 17.61°, 77.14° ± 19.43°, and 17.14° ± 10.97° to 126.43° ± 5.23°, 106.42° ± 11.72°, and 38.57° ± 14.57°, respectively, was observed (P < 0.001). Subjective outcome assessment showed that 13 of the 14 patients were very satisfied or satisfied with the operation, while one patient was uncertain due to co‐existing ipsilateral elbow lesion. Notably, one patient acquired a humeral periprosthetic fracture during the operation. In this study, no major complications such as periprosthetic joint infection and dislocation or implant loosening were observed. Further, no patients underwent revision for any reason at the end of the follow‐up.
Conclusions
RSA could achieve good early outcomes without high complication rates in patients with RA. Glenoid bone defects and adjacent joints involvement were common in this patient group, which might increase the risk of surgery and affect postoperative satisfaction.
Reverse shoulder arthroplasty could achieve good early outcomes without high complication rates in patients with rheumatoid arthritis. Glenoid bone defects and adjacent joints involvement were common in this patient group, which might increase the risk of surgery and affect postoperative satisfaction.</description><subject>Classification</subject><subject>Clinical</subject><subject>Clinical outcomes</subject><subject>Fractures</subject><subject>Hospitals</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Pain</subject><subject>Patient satisfaction</subject><subject>Reverse shoulder arthroplasty</subject><subject>Rheumatoid arthritis</subject><subject>Risk factor</subject><subject>Rotator cuff</subject><subject>Shoulder</subject><issn>1757-7853</issn><issn>1757-7861</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kU1r3DAQhkVpaT5a6E8Q9NJDnGpsy7J6KIQlTQKBDfk4i7Elr7XY1laSE_bfV41DIIfoMi-jh2eQhpBvwE4hnZ8unEIuKvmBHILgIhN1BR9fMy8OyFEIW8YqWQjxmRwUec0KCfUhGW_No_HB0LvezYM2np752Hu3GzDEPbUTvcFozRQDfbKxp7e9mUeMzuoFtNGGX_Qc_bCn6zm2bjThhN7Y2OEwpISTpqs-ZTNtTPhCPqV-MF9f6jF5-HN-v7rMrtcXV6uz66wta5AZlqUQTMq6RdBcY14JDp3BvNS5KRrUuuFMiqJECRyg4VJw3RR5gzlICVAck6vFqx1u1c7bEf1eObTqueH8RqGPth2M0rwWwBrTIfCScdmIrku1YXUldSXK5Pq9uHZzMxrdpr_wOLyRvr2ZbK827lGJSjDgLAm-vwi8-zubENXWzX5K71d5WTFZ1KzKE_VjoVrvQvCme50ATP1fsnJBPS85odmCPtnB7N_l1Ppu4f8Bf_am6A</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>He, Yong</creator><creator>Xiao, Lian‐bo</creator><creator>Zhai, Wei‐tao</creator><creator>Xu, Yue‐lin</creator><general>John Wiley & Sons Australia, Ltd</general><general>John Wiley & Sons, Inc</general><general>Wiley</general><scope>24P</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-8303-9570</orcidid></search><sort><creationdate>202010</creationdate><title>Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: Early Outcomes, Pitfalls, and Challenges</title><author>He, Yong ; Xiao, Lian‐bo ; Zhai, Wei‐tao ; Xu, Yue‐lin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4819-a44770998ca1d5da26751fea24d2e3baddb509734a91511b5975db32ba2199113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Classification</topic><topic>Clinical</topic><topic>Clinical outcomes</topic><topic>Fractures</topic><topic>Hospitals</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Pain</topic><topic>Patient satisfaction</topic><topic>Reverse shoulder arthroplasty</topic><topic>Rheumatoid arthritis</topic><topic>Risk factor</topic><topic>Rotator cuff</topic><topic>Shoulder</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>He, Yong</creatorcontrib><creatorcontrib>Xiao, Lian‐bo</creatorcontrib><creatorcontrib>Zhai, Wei‐tao</creatorcontrib><creatorcontrib>Xu, Yue‐lin</creatorcontrib><collection>Wiley-Blackwell Open Access Collection</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Orthopaedic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>He, Yong</au><au>Xiao, Lian‐bo</au><au>Zhai, Wei‐tao</au><au>Xu, Yue‐lin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: Early Outcomes, Pitfalls, and Challenges</atitle><jtitle>Orthopaedic surgery</jtitle><date>2020-10</date><risdate>2020</risdate><volume>12</volume><issue>5</issue><spage>1380</spage><epage>1387</epage><pages>1380-1387</pages><issn>1757-7853</issn><eissn>1757-7861</eissn><abstract>Objective
To evaluate the early outcomes and risk factors of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA).
Methods
A retrospective study was performed on RA patients who had undergone RSA between January 2016 and January 2018. Preoperative glenohumeral joint damage was evaluated according to two radiographic classification systems. The severity of joint damage was estimated using Larsen's method, while the Levigne‐Franceschi method was used to assess the type of destruction. Further, we recorded intra‐ and postoperative complications. Visual Analogue Scale (VAS) was used to assess the degree of shoulder pain while shoulder function was evaluated with the American Shoulder and Elbow Surgeons (ASES) Shoulder Score. In addition, patients' subjective outcome and range of shoulder motion were recorded. Radiographs were taken and examined during the follow‐up period. Paired t‐test was used to determine the difference in measurement data between preoperative and the last follow‐up. VAS was analyzed using the Wilcoxon matched‐pairs signed‐rank test.
Results
A total of 14 patients with 14 shoulders were included. All the patients were female with an average age of 60.29 years (range, 49–71 years) at the time of surgery and an average RA disease duration of 24.57 years (range, 5–40 years). Seven of the 14 patients had a history of joint surgery related to RA. Meanwhile, 11 of the 14 shoulders showed glenoid bone defect, and eccentric reaming was performed intraoperatively to avoid base plate malposition. The mean follow‐up period for the 14 patients was 2.76 years (range, 2–4 years). The mean VAS decreased from a value of 5.71 ± 1.10 preoperatively to 1.36 ± 0.61 postoperatively (P < 0.001). On the contrary, the ASES score showed an increase from 33.93 ± 6.89 to 76.67 ± 5.23 (P < 0.001). An increase in active forward elevation, abduction, and external rotation with the arm in 90° of abduction from 85.71° ± 17.61°, 77.14° ± 19.43°, and 17.14° ± 10.97° to 126.43° ± 5.23°, 106.42° ± 11.72°, and 38.57° ± 14.57°, respectively, was observed (P < 0.001). Subjective outcome assessment showed that 13 of the 14 patients were very satisfied or satisfied with the operation, while one patient was uncertain due to co‐existing ipsilateral elbow lesion. Notably, one patient acquired a humeral periprosthetic fracture during the operation. In this study, no major complications such as periprosthetic joint infection and dislocation or implant loosening were observed. Further, no patients underwent revision for any reason at the end of the follow‐up.
Conclusions
RSA could achieve good early outcomes without high complication rates in patients with RA. Glenoid bone defects and adjacent joints involvement were common in this patient group, which might increase the risk of surgery and affect postoperative satisfaction.
Reverse shoulder arthroplasty could achieve good early outcomes without high complication rates in patients with rheumatoid arthritis. Glenoid bone defects and adjacent joints involvement were common in this patient group, which might increase the risk of surgery and affect postoperative satisfaction.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>32803918</pmid><doi>10.1111/os.12769</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8303-9570</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley-Blackwell Open Access Collection; Publicly Available Content Database; PubMed Central |
| subjects | Classification Clinical Clinical outcomes Fractures Hospitals Joint replacement surgery Joint surgery Pain Patient satisfaction Reverse shoulder arthroplasty Rheumatoid arthritis Risk factor Rotator cuff Shoulder |
| title | Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: Early Outcomes, Pitfalls, and Challenges |
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