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

Abstract

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

Long-term Results of Shoulder Hemiarthroplasty in Patients With Rheumatoid Arthritis

“…A possible disadvantage of cemented hemiarthroplasty is severe glenoid erosion. [23][24][25][26] The purpose of the current retrospective study was to evaluate the long-term results of shoulder hemiarthroplasty in patients with RA and to provide recommendations for clinical practice and future research.…”

Reliability of proximal migration measurements in shoulder arthroplasty

“…It has been modified in successive studies, 2,7,23 as described above. Method 2 was the glenohumeral arc measurement (GHa), 1,11,19,20 defined by the distance between the inferior rim of the glenoid and the inferior margin of the humeral head. Method 3, the acromiohumeral distance (AH), is also used in the upward migration index 9,12,13,16,20 and is the distance between the most cranial part of the humeral head and the caudal cortex of the overlying acromion.…”

“…1,5,11,[20][21][22][23] Superior articulation of the glenohumeral joint has frequently been mentioned in relation to complications such as glenoid component loosening, glenoid erosion, or poor functional outcome, 1,3,5,10,14,23,24 although some studies have not found a clear relationship with outcome. 11,16,20 A reliable method for quantifying proximal migration that can be applied to large series of patients is a prerequisite if insight into its cause is to be obtained.…”

Relevante Unterschiede nach posttraumatischem und degenerativem Humeruskopfersatz (mittelfristige Resultate)

“…Die alleinige Arrosion am Glenoid war asymptomatisch[3,17,33]. Gemäû Sperling[36] ist jedoch die glenoidale Arthrose die häufigste Ursache für eine Reoperation und betrifft knapp die Hälfte der Patienten nach posttraumatischem Ersatz.Die limitierte Anzahl von Patienten schränkt naturgemäû die Aussagekraft dieser Studie ein.…”

“…5 b), wobei wir den Erfolg der in über 80 % intakten Rotatorenmanschette zuschreiben. Die schlechtesten Resultate erzielten in allen vergleichenden Studien die Patienten mit Polyarthritis, bei welchen die Manschette in den späteren Stadien häufig defekt ist und trotz positiver Beeinflussung des Schmerzes die Beweglichkeit weiterhin eingeschränkt bleibt[11,17,21].Die Indikation für einen primären posttraumatischen endoprothtetischen Humeruskopfersatz bei über 60-jährigen Patienten stellen wir bei luxierten 3-, allen 4-Fragment-Fraktu-ren sowie bei traumatischer Zerstörung mindestens der halben Kalottenfläche. Bei jüngeren Patienten ohne vorbestehende klinische und radiologische Zeichen einer schweren Omarthrose geben wir der gelenkserhaltenden Chirurgie den Vorrang.…”