Shoulder Replacement May Help for Severe Rheumatoid Arthritis01/30/14
THURSDAY, Jan. 30, 2014 (HealthDay News) -- Although hip and
knee replacements are common, a similar surgery to replace diseased
shoulder joints also appears worthwhile for rheumatoid arthritis
patients whose severe shoulder pain and stiffness can't be eased by
medication or physical therapy, new research suggests.
Scientists from the Mayo Clinic found that 93 percent of
rheumatoid arthritis patients who underwent a total shoulder
replacement -- in which both sides of a shoulder joint are replaced
-- needed no further surgery on the joint a decade later. The same
was true for 88 percent of those undergoing a partial shoulder
"We were most happy to see the consistency of pain relief and improvement of function among patients," said study author Dr. John Sperling, an orthopedic surgeon at the clinic in Rochester, Minn. "Shoulder replacement has come a long way over the past 20 to 25 years. It's a one-hour surgery that requires one night in the hospital, and patients have a 90 percent chance of achieving excellent pain relief."
The study, published in the February issue of the
Journal of Shoulder and Elbow Surgery, disclosed that two of
the researchers receive royalties from medical-device makers.
Shoulder-replacement surgery is performed far less often than
hip- or knee-joint replacements, but is done for the same reasons
-- to minimize pain and improve movement and function in diseased
joints, according to the study.
According to the Agency for Healthcare Research and Quality,
about 53,000 Americans underwent shoulder-replacement surgery in
2011. In contrast, more than 900,000 U.S. patients each year have
hips or knees replaced, according to the American Academy of
Shoulder pain is prevalent among those with rheumatoid
arthritis, an inflammatory disorder in which the immune system
attacks the body's own tissues, causing joint pain and other
problems. Shoulder-replacement surgery is also used for those with
more common osteoarthritis and for patients with complicated
shoulder fractures, Sperling said.
The procedure requires a 4- to 6-inch incision in the upper
shoulder region, where the diseased joint is removed and replaced
with a plastic or metal joint, Sperling said.
Analyzing more than 300 patients with rheumatoid arthritis who
had shoulder-replacement surgery at the Mayo Clinic, Sperling and
his team observed comparable surgical success rates both five years
and 10 years after the procedure. Only small percentages required
additional shoulder surgery during those time spans.
Dr. Anthony Romeo, a professor of orthopedics and director of
shoulder and elbow surgery at Rush University Medical Center in
Chicago, said the new study provides "tremendous insight" into the
results of shoulder replacement, which he said costs about
"Shoulder replacement has really found its place on par with hip replacement and knee replacement," said Romeo, who wasn't involved in the new research. "I hear very frequently in my office of patients saying they're very nervous about having a shoulder replacement because they've either never heard of it or it's so rare they're wondering how it can be a good option."
"I try to reassure my patients that this operation is as effective as hip or knee replacement," he said. "Shoulder replacement has moved ... to become a very predictable, reliable operation."
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