Resurfacing Hemiarthroplasty for the Treatment of Rheumatoid Arthritis of the Shoulder

Abstract

BackgroundThe present study reports a retrospective case series detailing our experience of the use of Copeland surface replacement hemiarthroplasty (CSRA) for the treatment of rheumatoid arthritis (RA) of the shoulder.MethodsFifty-three CSRAs were performed in 45 patients between 1994 and 2004. Forty-six shoulders were followed up at a mean of 62.5 months (range 24 months to 150 months). Assessment included a Constant score, patient satisfaction score, and plain radiographs.ResultsThe Constant score improved in all shoulders, from a pre-operative mean of 15.2 to 46.3. Mean abduction improved from 27° to 78°, mean flexion from 47° to 92°, and mean external rotation from 9° to 34°. Fifty-two percent of shoulders showed superior subluxation on plain radiographs. Seven shoulders had over 2 mm of glenoid erosion, of which one underwent reoperation. No implants were loose or required revision. One humeral neck fracture was successfully treated non-operatively. Four shoulders required arthroscopic subacromial decompression.DiscussionCSRA provides satisfactory results in RA compared to more conventional stemmed implants and total shoulder arthroplasty.