Simply defined, arthritis is inflammation of one or more of your joints. In 2011, more than 50 million people in the U.S.A. reported that they had been diagnosed with some form of arthritis. In an arthritis shoulder, inflammation causes pain and stiffness.
Although there is no cure for arthritis of the shoulder, there are many treatment options available. Using these, most people with arthritis can manage pain and stay active.
Shoulder Arthritis: http://www.youtube.com/watch?v=QUXJWP8W770
To provide you with effective treatment, your physician will need to determine which joint is affected and what type of arthritis you have.
Osteoarthritis is a condition that destroys the smooth outer covering (joint cartilage) of bone. As the cartilage wears away in the shoulder, it becomes thinned and rough, and the protective space between the bones decreases. The bones of the joint rub against each other ("bone-on-bone"), causing grinding sounds, stiffness and pain.
Osteoarthritis usually affects people over 50 years of age and is more common in the acromion-clavicular joint than in the gleno-humeral shoulder joint.
(Left) An illustration of damaged cartilage in the glenohumeral joint.
(Right) This x-ray of the shoulder shows osteoarthritis and decreased joint space (arrow).
Rheumatoid arthritis (RA) is a chronic disease that attacks multiple joints throughout the body. Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues. In RA, the defenses that protect the body from infection instead damage normal tissue (such as cartilage and ligaments) and soften bone. It is symmetrical, meaning that it usually affects the same joint on both sides of the body, or in this case, both shoulder joints.
The joints of your body are covered with a lining (synovium) that lubricates the joint and makes it easier to move. Rheumatoid arthritis causes the lining to swell, which causes pain and stiffness in the joint.
Rheumatoid arthritis is equally common in both joints of the shoulder.
A form of osteoarthritis that develops after an injury (such as a fracture or dislocation of the shoulder)
Arthritis can also develop after a large, long-standing rotator cuff tendon tear. The torn rotator cuff can no longer hold the head of the humerus in the glenoid socket, and the humerus can move upward and rub against the acromion. This can damage the surfaces of the bones, causing arthritis to develop. The combination of a large rotator cuff tear and advanced arthritis can lead to severe pain and weakness, and the patient may not be able to lift the arm away from the side.
Avascular necrosis (AVN) of the shoulder is a painful condition that occurs when the blood supply to the head of the humerus is disrupted. Because bone cells die without a blood supply, AVN can ultimately lead to destruction of the shoulder joint and arthritis.
Causes of AVN include high dose steroid use, heavy alcohol consumption, sickle cell disease, and traumatic injury, such as fractures of the shoulder. In some cases, no cause can be identified; this is referred to as idiopathic AVN.
After discussing your symptoms and medical history, your doctor will examine your shoulder.
During the physical examination, your doctor will look for:
To confirm the diagnosis, your doctor may inject a local anesthetic into the joint. If it temporarily relieves the pain, the diagnosis of arthritis is supported.
As with other arthritic conditions, initial treatment of arthritis of the shoulder is nonsurgical. Your doctor may recommend the following treatment options:
Shoulder Replacement: http://www.youtube.com/watch?v=dQvcWSzOhms
Reverse Shoulder Replacement: http://www.youtube.com/watch?v=tC8OXhELUGs
Your doctor may consider surgery if your pain causes disability and is not relieved with nonsurgical options.
(Left) A conventional total shoulder replacement (arthroplasty) mimics the normal anatomy of the shoulder.
(Right) In a reverse total shoulder replacement, the plastic cup inserts on the humerus, and the metal ball screws into the shoulder socket.
Dr van den Berg will opt for the reverse shoulder replacement surgery when possible as this yields better results than the traditional shoulder replacement surgery.
Surgical treatment of arthritis of the shoulder is generally very effective in reducing pain and restoring motion. Recovery time and rehabilitation plans depend upon the type of surgery performed.
As with all surgeries, there are some risks and possible complications. Potential problems after shoulder surgery include:
Your surgeon will discuss the possible complications with you before your operation.