The use of an extended humeral head (CTA) prosthesis in patients suffering with rheumatoid arthritis

Background The results of shoulder replacement in patients suffering with rheumatoid arthritis, particularly in the presence of a massive cuff tear and glenoid erosion, are often unsatisfactory. Although patients can achieve satisfactory pain relief, movement and function are often limited. In the present study, we report the use of the extended head prosthesis in this group of patients. Methods Thirty-two patients (33 shoulders) underwent this procedure and were followed up for a mean of 4 years. Results At review, as well as showing a statistically significant diminution in pain, movements, particularly flexion and external rotation, were also significantly improved. In addition, the American Shoulder and Elbow Surgeons and Constant–Morley function scores had also improved. The overall survivalship at 8 years was 93%. Discussion We consider that these results are comparable if not better than a standard hemi-arthroplasty. In some cases, however, radiological follow-up has shown progressive subacromial and glenoid erosion. The significance of this remains unknown at present. Finally, in one patient, the humeral head subluxed anteriorly, resulting in revision to a reverse prosthesis.