Late results of total shoulder replacement in patients with rheumatoid arthritis

Rheumatoid arthritis of the shoulder is a progressive and destructive joint disease, and similar to arthritis in other joints, progression of the dise ase is unpredictable and may stop at any stage of involvement. Between 1983 and 1996, more than 500 shoulder prostheses were implanted in patients at the authors' institution, Total shoulder replacement yields satisfactory sh ort and long term results even in patients with severely destructed joints, Pain relief is reliable and significant as reported in short and long term studies, In most patients the functional result is good or acceptable. Alt hough range of motion is only slightly increased, a satisfactory overall ra nge of motion is achieved by most patients because of the unaffected scapul othoracic motion, However, deteriorating results, emphasizing the complexit y of shoulder arthroplasty, were seen with increasing observation time in p atients with rheumatoid arthritis. Proximal migration of the humeral prosth esis attributable to rotator cuff failure, with secondary eccentric glenoid loading and progressive loosening, is latent in patients with chronic prog ressive rheumatoid disease and was by far the most common complication (42 %) in the present series.