1998 Volume 22 Issue 2 Pages 245-247
[Purpose] We previously reported that patterns of shoulder joint destruction in rheumatoid arthritis (RA) could be classified into 5 groups: non-progressive (N) with normal radiographs, erosive (E)showing marginal erosion, but no collapse, collapse (C) showing a subchondral cyst,, followed by collapse, arthrosis-like (A) showing osteoarthritic features, and mutilating (M) showing mutilating bone destruction. In this study, we analyzed the results of RA shoulder surgery for each group with a different destruction pattern.
[Materials and Methods] 43 RA patients (53 shoulders) who under went shoulder surgery were studied.43 patients consisted of 5 males and 38 females, and this mean age was 51 (28-76) years. The mean duration of the disease was 12 (3-36) years.
21 synovectomies (6 N types,11 E t ypes, and 4 C types) and 32 prosthetic replacements (9 E types,14 C types, and 9 M types) were studied.
[Results] Synovectomy was effective for N type of shoulder joint destruction. It was also effective for E types in the early disease course. Prosthetic replacement was effective for E type in the late disease course. Synovectomy was not effective for C type, but prosthetic replacement was. A prosthetic replacement was effective only for reducing pain for M type.
[Conclusion] Our classification of RA shoulder joint destruction was useful in selecting the treatment, including surgery.
