In 1893 the French surgeon J.P. Péan performed the first shoulder joint replacement on a patient with shoulder destruction due to tuberculosis. The prosthesis was designed by the French dentist Michael and was made of platinum and rubber. The surgery proved to decrease pain and improve shoulder function. In recent years there has been great progress in shoulder arthroplasty. In this article different types of shoulder prostheses are described together with indications and risks of surgical treatment in rheumatoid arthritis.
The described methods of physiotherapy refer to pre-operation, early post-operation and the late phase in patients with rheumatoid arthritis. The authors present physiotherapy guidelines starting from the first day after the operation, including the use of orthopaedic and physiotherapy equipment. The suggested physiotherapy includes introduction of progressive active motion and other methods adjusted to patients with severe rheumatoid arthritis.