The Journal of Bone and Joint Surgery, Vol 69, Issue 5 661-666, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Arthroplasty of the ipsilateral shoulder and elbow in patients who have rheumatoid arthritis
RJ Friedman and FC Ewald
Over a ten-year period, arthroplasty of the ipsilateral shoulder and elbow
was performed in thirty-five extremities of thirty-one patients who had
advanced rheumatoid arthritis. The results of the procedures were
retrospectively reviewed to determine the appropriate sequence of surgery
and the functional results that were obtained. All patients were followed
for a minimum of two years after the last arthroplasty. The elbow had been
operated on first in twenty-one extremities and the shoulder had been
operated on first in fourteen. The time-interval between arthroplasties was
significantly longer (p less than 0.005) when the elbow had been operated
on first (forty-five compared with 13.4 months). All motion of the elbow
and elevation and external rotation of the shoulder improved significantly
(p less than 0.005), similar to the improvement in motion that is noted
when either joint is operated on alone. Also, there was a highly
significant reduction in pain and improvement in function (both, p less
than 0.001). Review of the roentgenograms of twenty-three patients
demonstrated no humeral fractures or interference in the proper placement
of the humeral component of the prosthesis either by the stem of the other
prosthesis or by the methylmethacrylate. All of the arthroplasties of the
shoulder that were performed as the second arthroplasty were done at least
five months after the arthroplasty of the elbow, and no dislocations or
subluxations of the components of the elbow prosthesis occurred.(ABSTRACT
TRUNCATED AT 250 WORDS)
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