Reverse shoulder prosthesis in patients with rheumatoid arthritis: a systematic review

Postacchini, Roberto; Carbone, Stefano; Canero, G.; Ripani, M.; Postacchini, Franco

doi:10.1007/s00264-015-2916-2

Cited by 24 publications

(12 citation statements)

References 54 publications

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“…11 For this reason, interest in the reverse TSA for the RA patient population has increased since its introduction in the US in 2004; 16 in fact, in RA patients with endstage inflammatory arthropathy and a damaged rotator cuff, the reverse TSA has demonstrated excellent results. [17][18][19][20] Based upon this evidence, it is not surprising that we found an exponential rise in the use of the reverse TSA since 2010, which corresponds to the introduction of an ICD-9 code for this implant. 21 Prior to 2010, it is likely that many implanted reverse TSAs were coded as TSA, and for this reason, we believe that the observed rise in the utilization of TSA in RA patients prior to 2010 may have been partly fueled by an increase in the use of the reverse TSA.…”

Section: Discussionmentioning

confidence: 64%

Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Population-Based Study Examining Utilization, Adverse Events, Length of Stay, and Cost

Leroux¹,

Basques²,

Saltzman

et al. 2018

Am J Orthop

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It has been suggested that the utilization of joint arthroplasty in patients with rheumatoid arthritis (RA) is decreasing; however, this observation is largely based upon evidence pertaining to lower-extremity joint arthroplasty. It remains unknown if these observed trends also hold true for shoulder arthroplasty. The purpose of this study is to utilize a nationally representative population database in the US to identify trends in the utilization of shoulder arthroplasty among patients with RA. Secondarily, we sought to determine the rate of early adverse events, length of stay, and hospitalization costs associated with RA patients undergoing shoulder arthroplasty and to compare these outcomes to those of patients without a diagnosis of RA undergoing shoulder arthroplasty. Using a large population database in the US, we determined the annual rates of shoulder arthroplasty (overall and individual) in RA patients between 2002 and 2011. Early adverse events, length of stay, and hospitalization costs were determined and compared with those of non-RA patients undergoing shoulder arthroplasty. Overall, we identified 332,593 patients who underwent shoulder arthroplasty between 2002 and 2011, of whom 17,883 patients (5.4%) had a diagnosis of RA. Over the study period, there was a significant increase in the utilization of shoulder arthroplasty in RA patients, particularly total shoulder arthroplasty. Over the same period, there was a significant increase in the number of RA patients who underwent shoulder arthroplasty with a diagnosis of rotator cuff disease. There were no significant differences in adverse events or mean hospitalization costs between RA and non-RA patients. Non-RA patients had a significantly shorter length of stay; however, the difference did not appear to be clinically significant. In conclusion, the utilization of shoulder arthroplasty in patients with RA significantly increased from 2002 to 2011, which may partly reflect a trend toward management of rotator cuff disease with arthroplasty rather than repair.

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Section: Discussionmentioning

confidence: 64%

Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Population-Based Study Examining Utilization, Adverse Events, Length of Stay, and Cost

Leroux¹,

Basques²,

Saltzman

et al. 2018

Am J Orthop

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“… 28 29) One was based on the only 5 studies that met their inclusion criteria. 28) The other included 7 studies for critical appraisal and data extraction as in our study. However, there were some differences in the method to analyze the results.…”

Section: Discussionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Systematic Review

Cho

Song

2017

Clin Orthop Surg

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BackgroundThere are limited data available regarding the results of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA). We performed a systematic review of the literature to investigate the radiological and clinical outcomes after RSA in patients with RA.MethodsA literature search for publications between 1987 and 2014 was conducted by 2 independent reviewers using PubMed, Scopus, Embase, and Cochrane Central Register of Controlled Trials. Articles were retrieved by an electronic search using keywords and their combinations. Studies that met inclusion criteria were assessed for pertinent data.ResultsSeven studies including 123 shoulders met the inclusion criteria. The mean age of the patients was 67.9 years and the mean follow-up period was 46.6 months. The mean Constant score and American Shoulder and Elbow Surgeons (ASES) score increased from 18.6 and 27.5 preoperatively to 58.6 and 73.7, respectively, at the final follow-up evaluation. The mean active forward flexion, abduction, and external rotation increased from 57.2°, 50.4°, and 11.4° to 127.1°, 116.7°, and 26.4°, respectively. The incidence of scapular notching was 33.7%. Twenty-seven (22.0%) of 123 shoulders had one or more complications, 12 of which (44.4%) had intraoperative or postoperative fractures. Nine shoulders (7.3%) had one or more revision surgeries.ConclusionsRSA in RA showed similar short- to mid-term results without higher complication rates as compared to RSA in cuff tear arthropathy. Although RSA can be considered a reliable treatment option in patients with RA, further large-scale studies are required to determine the long-term survival of the implant.

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“…To address rotator cuff dysfunction, RSA has been used to treat shoulder destruction associated with RA in recent years. Good clinical outcomes fueled a significant increase in the number of RSA compared with the inevitable decrease of knee and hip arthroplasty utilization in RA patients as a result of revolutionary improvement in medication therapy 11,12 . In a recent study, Leroux et al 13 conducted a population-based investigation using Nationwide Inpatient Sample and found a significant increasing trend of utilization of shoulder arthroplasty in RA patients in the United States.…”

Section: Introductionmentioning

confidence: 99%

“…In a systematic review, Cho et al 12 searched the literature from 1987 to 2014 and only found seven relevant studies, all with small sample that varied from eight to 27 cases. Furthermore, surgical complications such as prosthetic joint infection (PJI) and periprosthetic fracture are more common in RA patients compared with other indications due to poor bone and soft tissue conditions, and use of immunosuppressive drugs 11,15 . A meta-analysis indicated that the risk of PJI in patients with RA was significantly higher than that in patients with osteoarthritis 16 .…”

Section: Introductionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: Early Outcomes, Pitfalls, and Challenges

Xiao

Zhai

et al. 2020

Orthopaedic Surgery

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Objective: To evaluate the early outcomes and risk factors of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA). Methods: A retrospective study was performed on RA patients who had undergone RSA between January 2016 and January 2018. Preoperative glenohumeral joint damage was evaluated according to two radiographic classification systems. The severity of joint damage was estimated using Larsen's method, while the Levigne-Franceschi method was used to assess the type of destruction. Further, we recorded intra-and postoperative complications. Visual Analogue Scale (VAS) was used to assess the degree of shoulder pain while shoulder function was evaluated with the American Shoulder and Elbow Surgeons (ASES) Shoulder Score. In addition, patients' subjective outcome and range of shoulder motion were recorded. Radiographs were taken and examined during the follow-up period. Paired t-test was used to determine the difference in measurement data between preoperative and the last follow-up. VAS was analyzed using the Wilcoxon matched-pairs signed-rank test. Results: A total of 14 patients with 14 shoulders were included. All the patients were female with an average age of 60.29 years (range, 49-71 years) at the time of surgery and an average RA disease duration of 24.57 years (range, 5-40 years). Seven of the 14 patients had a history of joint surgery related to RA. Meanwhile, 11 of the 14 shoulders showed glenoid bone defect, and eccentric reaming was performed intraoperatively to avoid base plate malposition. The mean follow-up period for the 14 patients was 2.76 years (range, 2-4 years). The mean VAS decreased from a value of 5.71 ± 1.10 preoperatively to 1.36 ± 0.61 postoperatively (P < 0.001). On the contrary, the ASES score showed an increase from 33.

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Reverse shoulder prosthesis in patients with rheumatoid arthritis: a systematic review

Abstract: RSA implanted in RA patients would appear to give similar results to those obtained in massive cuff tears with or without arthropathy.

Cited by 24 publications

References 54 publications

Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Population-Based Study Examining Utilization, Adverse Events, Length of Stay, and Cost

Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Population-Based Study Examining Utilization, Adverse Events, Length of Stay, and Cost

Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Systematic Review

Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: Early Outcomes, Pitfalls, and Challenges

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