Comparison of outcomes after reverse shoulder arthroplasty in patients with rheumatoid arthritis and cuff tear arthropathy

Abstract

Background The reverse shoulder arthroplasty (RSA) was originally designed for cuff tear arthropathy (CTA). Over time, the indications have expanded to rheumatoid arthritis (RA). This study aimed to compare the outcomes of RSA in patients with RA and CTA to determine if there is any impact on clinical and radiographic outcomes. Methods In this retrospective comparative study (performed from August 2010 to March 2017), 61 shoulders from 59 consecutive patients (RA group: 24 patients [26 shoulders], CTA group: 35 patients [35 shoulders]) who underwent primary RSA, were included. The average follow-up period was 31 months (range, 24-64 months). Patients were assessed with the use of the visual analog scale pain score, the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score, the Single Assessment Numeric Evaluation score, range of motion (ROM), and imaging studies included the β angle, glenoid component superior tilt, and scapular notching. Results The clinical results improved significantly in both groups, but there was no statistically significant difference between the RA group and the CTA group. Significant intergroup differences were observed regarding the β angle (73° ± 11° for the RA group vs. 85° ± 8° for the CTA group; P Conclusion Compared with CTA patients, RA patients achieved similar clinical outcomes following RSA. However, surgeons should pay attention to the positioning of the glenoid component during the surgery and the risk of intraoperative fractures in RA patients.