Mayo Study: Shoulder Replacement Helps RA Patients

A new Mayo Clinic study has found that despite surgical challenges with some rheumatoid arthritis (RA) patients, shoulder replacement surgery improves range of motion and reduces pain in nearly all cases, especially for those with intact rotator cuffs. Researchers used the Mayo Clinic Total Joint Registry to study 303 patients with rheumatoid arthritis who had shoulder replacement at Mayo Clinic and were followed by physicians for at least five years. The findings are published in the Journal of Shoulder and Elbow Surgery.

“I think it’s quite encouraging, ” said senior author John Sperling, M.D., an orthopedic surgeon at Mayo Clinic in Rochester, in the January 13, 2014 news release. “What we’ve learned from this study is that if people do develop significant pain in their shoulder due to arthritis associated with rheumatoid arthritis, shoulder arthroplasty really is a predictable and reliable operation to help them improve their function and relieve pain.”

Of those who had total shoulder replacement, in which both sides of a shoulder joint was replaced, 96% were still alive and had no need for further arthroplasty on the affected shoulder five years later, and 93% were alive with no need for additional surgery a decade later. Among those who had only one side of a joint replaced, known as partial arthroplasty, those statistics were roughly 89% five years after shoulder replacement and 88% ten years after the surgery. Patients with intact rotator cuffs did better after shoulder replacement than those with damaged rotator cuffs, researchers say.

Dr. Sperling told OTW, “The study shows that it’s a very predictable operation for improving pain as well as function. The other aspect of this study that’s important is that replacing both sides of the joint is important to be able to maximize the outcome of the operation. There’s been some discussion about just doing a partial shoulder replacement, but what this study shows is that the total replacement really is the preferable operation for these patients. We also found out patients whose rotator cuff was intact did better in terms of pain and function. The other thing the study shows is that the chance of needing an additional operation is actually quite low, which we found to be very encouraging.”

He added, “Further research is planned on shoulder replacement outcomes for arthritis patients, using the Mayo Clinic Total Joint Registry. What we’ve done is divided up each individual group of patients from rheumatoid arthritis to traumatic arthritis, different types of arthritis, to truly try to understand what are the risk factors for a poor outcome or the factors in a good outcome and try to understand better what we can do to help our patients.”