Nine shoulders in 7 patients with rheumatoid arthritis were treated with 8 Neer and one Kessel total shoulder arthroplasties. The clinical follow-up was done for a mean of 40 months (range 3 to 122) . Clinical symptoms of pain and joint function were quite improved. However, the range of movement was not changed in elevation, though slightly improved in external rotation. Radiological findings revealed radiolucent lines around the glenoid component in 3 patients (33%), and proximal migration of the humeral head in only one (11%) . There was no clinical evidence (motion pain) of loosening.
The joint kinetics after total shoulder arthroplasty in active elevation were recorded with a video recorder through an image intensifier, and the images obtained were analyzed by an analyzing system (MOVIAS, NAC HSV-400) . It was shown that scapulo-thoracic movement is larger than gleno-humeral movement in active elevation. Although postoperative improvement of ROM of the shoulder was poor, total shoulder arthroplasty was a valuable procedure for these patients with painful shoulder with respect to pain relief and improvement in ADL.
