PREVENTIVE SURGICAL-TREATMENT OF THE RHEU MATOID SHOULDER

According to the data in the literature, about 70 to 90 per cent of ca ses of rheumatoid arthritis also involve the shoulder. In spite of thi s, surgical treatment of the rheumatic shoulder has long been neglecte f for a wide variety of reasons. Meanwhile, adequate surgical treatmen t methods have become available, partly also because of improved diagn ostic procedures, for treating all stages of the rheumatically destroy ed shoulder. Indication for operation depends on the x-ray stage accor ding to Larsen, Dahle and Eeg, as well as on the clinical and sonograp hic findings. Between June 1985 and June 1993 we treated a total of 11 8 shoulders non-endoprosthetically. The patients were clinically exami ned in respect of pain, mobility and strength. We also assessed the x- ray of pain, mobility and strength. We also assessed the x-ray and son ographic findings as well as the subjective result in the patient. In most cases there was considerable improvement in the parameters paiun, mobility and strength. Subjectively, the majority of the patients rat ed the result as good to excellent. In respect of the x-rav result the re was a deterioration especially of the secondary arthrotic process. The sonographic controls were notable for a high rate of redefects of the rotator cuff.