The effects of surgical treatment in the management of the shoulder in people with rheumatoid arthritis are largely unknown due to the paucity of randomised controlled trials.
Augmented subscapularis muscle transposition for rotator cuff repair during shoulder arthroplasty in patients with rheumatoid arthritis.
The effectiveness of rotator cuff repair by augmented subscapularis transposition via the Leeds-Keio artificial ligament was evaluated in patients with rheumatoid arthritis undergoing total shoulder arthroplasty. The minimum follow-up period was 2 years. Final clinical scores (Hospital for Special Surgery scoring system) and the incidence of radiolucency and upward migration of shoulder components in 20 shoulders with rotator cuff repair by augmented subscapularis transposition were superior to those of 19 shoulders with cuff repair by subscapularis transposition alone and similar to those of 22 shoulders with intact rotator cuffs. In shoulders with augmented subscapularis transposition and intact cuffs, clinical scores continued to improve even after the first postoperative year. Our augmented subscapularis transposition did not increase postoperative complications. We conclude that cuff repair by augmented subscapularis transposition is an acceptable alternative for repairing a supraspinatus or supraspinatus and infraspinatus rotator cuff defect in rheumatoid arthritis patients undergoing total shoulder arthroplasty.