WWE Royal Rumble 2019 saw a United States Championship Match take place between Shinsuke Nakamura and Rusev. Rusev won the United States Championship at the end of last year on the Christmas Day show. He looked like he was in for a big run as the Champion, but it was not to be.
Rusev appeared to be doing well until Lana saw that Shinsuke Nakamura was attempting to cheat. She got up on the apron to protest and draw the attention of the referee, with Nakamura telling her to go away. However, Rusev was the one disadvantaged, as he tried to attack Nakamura from behind, but he got away. Instead, he knocked down Lana which in turn distracted him.
— WWE (@WWE) January 27, 2019
This ended with Nakamura taking advantage and hitting Rusev with the Kinshasa. Rusev was not able to react in time and instead was pinned by Shinsuke Nakamura. Nakamura thus won back his WWE United States Championship, with Rusev losing the title hardly having done anything with it.