Objective. To develop and evaluate the effect of a new arthritis education program based on a previous studyMethods. One

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Rheumatoid arthritis frequently involves the shoulder. In the advanced stages of the disease the preferred treatment has been either arthroplasty or arthrodesis. The functional results of five shoulder arthrodeses have been compared with five hemiarthroplasties. The period of postoperative immobilization was shorter for hemiarthroplasty; both procedures relieved pain, but personal hygiene was easier to manage after hemiarthroplasty. Shoulder arthrodesis with a fixed internal rotation greater than 40 degrees makes it impossible to reach the face and the optimal position would seem to be 20-30 degrees of abduction. 20-30 degrees flexion and 20-30 degrees internal rotation.

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Patients with severely deforming rheumatoid arthritis and impaired function of the upper extremity are often unable to use conventional walking aids. This report describes 42 such patients who were equipped with altogether 75 individually manufactured, lightweight walking aids (12 crutches, 12 forearm-crutches, 39 crutch-sticks and 12 sticks). A plaster cast of the patient's grip as well as analysis of the integrated function of the shoulder-elbow-wrist was used when preparing the walking aid. It was thereby possible to produce suitable walking aids for all but one patient. At follow-up after 12-18 months, of use, most patients belonging to functional classes II and III were satisfied with their walking aid(s) and 22 considered it/them indispensable. However, in 4 patients, progressive disease with increased disease activity/deteriorating hand function and in 3 patients increasing shoulder pain reduced their usability. Lack of motivation was one reason for low use intensity. Follow-up demonstrated that most patients were able to use these walking aids without detectable negative effects on the upper extremity. The durability of the walking aid was satisfactory. Thus an individually moulded handle on an adapted lightweight walking aid is important helping patients with severely deforming arthritis to maintain independent ambulation, and should be made more widely obtainable.