Reliability of stemless shoulder arthroplasty in rheumatoid arthritis: observation of early lysis around the humeral component

被引：2

作者：

Jordan R.W. ^{[1
]}

Manoharan G. ^{[1
]}

Van Liefland M. ^{[1
]}

Dodenhoff R. ^{[1
]}

Hay S.M. ^{[1
]}

Kelly C.P. ^{[1
]}

Potter R.P. ^{[1
]}

机构：

[1] Robert Jones and Agnes Hunt Hospital, Oswestry, Gobowen

来源：

MUSCULOSKELETAL SURGERY | 2021年 / 105卷 / 2期

关键词：

Inflammatory arthropathy; Rheumatoid arthritis; Shoulder arthroplasty; Stemless shoulder replacements;

D O I：

10.1007/s12306-019-00629-8

中图分类号：

学科分类号：

摘要：

Purpose: To evaluate whether stemless shoulder implants in rheumatoid arthritis (RA) patients provide comparable functional outcomes to patients with osteoarthritis or post-traumatic arthritis. In addition, the study assessed for differences in incidence of radiolucent lines or proximal humeral bone loss during radiographic follow-up. Methods: Consecutive stemless shoulder arthroplasties performed in RA patients and a matched control group were retrospectively identified between February 2012 and 2018. Thirty-five patients were included in each group: 24 total shoulder arthroplasty (TSA) and 11 hemiarthroplasty (HA). Patients were evaluated annually using the Oxford Shoulder Score (OSS) and radiographically. Results: The mean OSS significantly improved in all groups until 24 months. The mean improvement for RA TSA and HA patients at 24 months was 19.86 (95% CI 10.66–29.05, p = 0.0004) and 19.71 (95% CI 7.33–32.31, p = 0.0084), respectively. The mean improvement in the control TSA and HA patients at 24 months was 20.86 (95% CI 17–24.71, p = 0.0001) and 17.86 (95% CI 1.36–34.35, p = 0.0381), respectively. During the study period, two patients in the RA TSA group (8%), one patient in the control TSA group (4%) and one patient in the control HA group (9%) required revision. The proportion of progressive proximal humeral bone loss after TSA was 33% in the RA group and 13% in the control group. Conclusion: Stemless shoulder implants can provide significant improvement in functional scores in RA patients in the short term. However, early bone loss around the humeral implant is a concern and the authors recommend long-term clinical and radiological follow-up. © 2019, Istituto Ortopedico Rizzoli.

引用

页码：139 / 148

页数：9

共 37 条

[31]

Lehtinen J.T., Kaarela K., Belt E.A., Kautiainen H.J., Kauppi M.J., Lehto M.U., Incidence of glenohumeral joint involvement in seropositive rheumatoid arthritis. A 15 year endpoint study, J Rheumatol, 27, 2, pp. 347-350, (2000)

[32]

Larsen A., Dale K., Eek M., Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films, Acta Radiol Diagn (Stockh), 18, 4, pp. 481-491, (1977)

[33]

Tanaka H., Sugamoto K., Sahara W., Ono T., Tomita T., Hashimoto J., Yoshikawa H., The mode of destruction in shoulders with rheumatoid arthritis based on radiographic findings, J Shoulder Elbow Surg, 16, 5, pp. 539-543, (2007)

[34]

Ravi B., Escott B., Shah P.S., Jenkinson R., Chahal J., Bogoch E., Kreder H., Hawker G., A systematic review and meta-analysis comparing complications following total joint arthroplasty for rheumatoid arthritis versus for osteoarthritis, Arthritis Rheum, 64, 12, pp. 3839-3849, (2012)

[35]

Somayaji R., Barnabe C., Martin L., Risk factors for infection following total joint arthroplasty in rheumatoid arthritis, Open Rheumatol J, 7, pp. 119-124, (2013)

[36]

Lehtinen J.T., Belt E.A., Lyback C.O., Kauppi M.J., Kaarela K., Kautiainen H.J., Lehto M.U.K., Subacromial space in the rheumatoid shoulder: a radiographic 15-year follow-up study of 148 shoulders, J Shoulder Elbow Surg, 9, pp. 183-187, (2000)

[37]

Trappey G.J., O'Connor D.P., Bradley Edwards T., What are the instability and infection rates after reverse shoulder arthroplasty?, Clin Orthop Relat Res, 469, pp. 2505-2511, (2011)

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