Rheumatoid Arthritis and Shoulder Replacement

Joint replacement surgery to ease shoulder pain and improve limited range of motion caused by rheumatoid arthritis can pose unique challenges to doctors.

Because rotator-cuff tears and low bone density are common in people with rheumatoid arthritis, a replacement shoulder joint may be susceptible to both loosening components and bone fractures around the implant. What’s more, people with rheumatoid arthritis may be taking immunosuppressive drugs, which puts them at risk for an infection in the replacement joint.

But a study published in the Journal of Shoulder and Elbow Surgery in 2014 suggests that complications from a total shoulder replacement, or arthroplasty, may be overstated. Researchers followed 313 people with rheumatoid arthritis who had shoulder arthroplasties. After 10 years, they found that roughly 93 percent of patients who underwent a total shoulder arthroplasty had significant pain relief and improved shoulder function, needing no further surgical revisions during that time.

And about 88 percent of patients who underwent a partial shoulder arthroplasty found long-lasting relief, too. Although shoulder replacement isn’t nearly as common as hip or knee replacements, the study authors say doctors should consider it as a treatment option more often than they do now—the surgery typically takes about an hour to perform, and many patients can resume activities such as driving, gardening, and golfing six weeks after surgery.