Neer total shoulder replacement in rheumatoid arthritis

Kelly, I.G.; Foster, R.R.; Fisher, W D

doi:10.1302/0301-620x.69b5.3680331

Cited by 132 publications

(73 citation statements)

References 8 publications

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“…Our patients had no improvement in motion-perhaps because of the severe rotator cuff destruction preoperatively (Cofield 1984, Kelly et al 1987. Proximal subluxation of the humeral head is usually regarded as a sign of rotator cuff disease.…”

Section: Discussionmentioning

confidence: 62%

“…A shoulder prosthesis has been reported to relieve pain in more than 90% of the patients with rheumatoid arthritis (Marmor 1977, Cofield 1984, Kelly et al 1987, Barret et al 1989, McCoy et al 1989, Vahvanen et al 1989, Boyd et al 1990). These reports showed no difference in pain relief between a hemiand a total shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…There remains doubt about the long-term adequacy of fixation of the glenoid component, especially in patients with rheumatoid arthritis (Kelly et al 1987, Barret et al 1989, McCoy et al 1989, Boyd et al 1990). In hemiarthroplasty, destruction of the glenoid is likely to occur.…”

Section: Discussionmentioning

confidence: 99%

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Shoulder hemiarthroplasty in rheumatoid arthritis 19 cases reexamined after 1-17 years

Koorevaar

Merkies

Malefijt

et al. 1997

Acta Orthopaedica Scandinavica

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We reexamined 19 shoulder hemiarthroplasties in proximal subluxation of the head of the humeral patients with rheumatoid arthritis after a mean of 8 prosthesis and in 9/15 shoulders, progression of the (1-17) years. For the evaluation, we used the glenoid erosion were seen. The increase in glenoid Constant and Murley score and routine radiographs. erosion and the postoperative pain were not correAt the follow-up examination, 12 of the 19 shoulders lated. Hemiarthroplasty of the shoulder effectively showed little, if any, pain. In 7 shoulders the pain relieves the pain in rheumatoid patients and this was moderate and no patient had severe pain. The seems long-lasting. range of motion was not improved. In 7/18 shoulders

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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Shoulder hemiarthroplasty in rheumatoid arthritis 19 cases reexamined after 1-17 years

Koorevaar

Merkies

Malefijt

et al. 1997

Acta Orthopaedica Scandinavica

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“…Previous studies did not note clinical loosening after TSA, although the frequency of a radiolucent line in the glenoid component was high; these studies recommended TSA over hemiarthroplasty for RA patients. 29,37) Considering these previous findings, TSA appears to be better than hemiarthroplasty for pain relief in RA shoulders with an intact rotator cuff; however, in patients with a thin or torn rotator cuff, surgical procedure should be carefully selected because both TSA and hemiarthroplasty are associated with its respective disadvantages (glenoid loosening associated with TSA and painful glenoid arthritis associated with hemiarthroplasty). In TSA and hemiarthroplasty for RA shoulders, the occurrence of superior migration of the humeral head is high, owing to rotator cuff rupture or altered balance between the deltoid and cuff muscles (Fig.…”

Section: Hemiarthroplasty and Total Shoulder Arthroplastymentioning

confidence: 98%

“…32,36) Superior subluxation shows predisposition to the impingement of greater tuberosity on the acromion during elevation, thus reducing the range of motion at the glenohumeral joint, whether the cuff is functional or not. 37) In RA patients, the coracoacromial arch should preferably be kept intact, because it is an important structure to counteract the tendency for anterosuperior subluxation of the humeral head during TSA or hemiarthroplasty. Many studies have recommend the use of cemented humeral components rather than the use of uncemented humeral components due to the high rate of loosening with the latter as a result of poor bone quality in RA patients.…”

Section: Hemiarthroplasty and Total Shoulder Arthroplastymentioning

confidence: 99%

Surgical Treatment for the Shoulder Joint in Rheumatoid Patients

Yoon¹,

Jo²,

Lee³

2016

Clinics in Shoulder and Elbow

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Microcomputed tomography assessment of glenoid component cementation techniques in total shoulder arthroplasty

Hasan

Mueller

Syed

et al. 2009

Journal Orthopaedic Research

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Various strategies have been described to improve glenoid component cementation technique in shoulder arthroplasty, such as the ''weephole'' technique (WH), which is thought to allow for improved cement mantles by suction venting the glenoid vault through the coracoid. The purpose of this study was to compare the cement mantle created using standard syringe pressurization (SP) to WH or a new, modified weephole technique (MWH), not requiring specific instrumentation of the coracoid medullary canal. Fourteen cadaveric scapulae underwent preparation of the glenoid to allow for implantation of glenoid components. Component fixation was achieved using SP, WH, or MWH. The volumes of cement surrounding each individual peg on the component, of the cement mantle between the back of the glenoid, and of the reamed glenoid face were quantified using micro-CT. Total shoulder arthroplasty is an efficacious treatment for advanced arthritis of the glenohumeral joint with high patient satisfaction rates. 1-5 However, glenoid component radiolucent lines and potential associated loosening are continued areas of concern. 6-9 Radiolucencies, both early and late, are common with rates ranging from 26 to 94%. 1,7,[9][10][11][12][13][14][15][16] Initially their significance was unclear; however, several studies documented progression of radiolucent lines that correlated with clinical loosening of the glenoid component, resulting in decreased function. 7,17 Changes in component design, instrumentation, and cement techniques have all been employed to improve glenoid component fixation and decrease the incidence of radiolucent lines. 6,[18][19][20] The presence of radiolucent lines on immediate postoperative films has been commonly reported. 1,9,12,[20][21][22][23][24][25] These lines are considered an indicator of technical failure or a limitation of the cement technique. 1,12,20,22,26 Gross et al. 27 suggested that the unique anatomy of the glenoid, functioning as a ''cortical box,'' with a limited amount of cancellous bone, is a significant contributing factor to the presence of postoperative radiolucent lines with the radiolucencies representing trapped fluid in the glenoid vault. They described a ''weephole'' (WH) technique for venting the vault and applying suction to improve the fluid dynamics in the glenoid vault and cement penetration into cancellous bone. 27 The technique requires the creation of a burr hole through the superior cortex of the coracoid, followed by cannulation with a curette of the glenoid vault and either the superior peg hole or keel slot depending on component design.Based upon the anatomical relationship of confluence between the medullary canal of the coracoid and the glenoid vault, we hypothesized that the vault could be vented simply by making a burr hole in the cortex of the coracoid base through which to apply suction. This would simplify the WH technique, as no further instrumentation of either the coracoid medullary canal or the glenoid vault would be required, thereby limiting the risk of pr...

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Neer total shoulder replacement in rheumatoid arthritis

Abstract: Between 1979 and 1984, 43 Neer total shoulder arthroplastics were performed on 38 patients with polyarthritis in the University Department of Orthopaedic Surgery, Glasgow ; one patient died of unrelated causes within six months of surgery and has been excluded from the study.

Cited by 132 publications

References 8 publications

Shoulder hemiarthroplasty in rheumatoid arthritis 19 cases reexamined after 1-17 years

Shoulder hemiarthroplasty in rheumatoid arthritis 19 cases reexamined after 1-17 years

Surgical Treatment for the Shoulder Joint in Rheumatoid Patients

Microcomputed tomography assessment of glenoid component cementation techniques in total shoulder arthroplasty

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