Millions of people have been diagnosed with some form of arthritis. While some people go many years without having symptoms, others experience rapid progression of pain that can be debilitating. The bony joint surfaces are coated by a smooth covering called cartilage. Osteoarthritis involves wearing of the cartilage over time which exposes the bone and development of bony growths called spurs. As cartilage wears away, the bony surfaces of the joint come in contact with each other, which can cause symptoms such as grinding, pain, and decreased range of motion. Rheumatoid arthritis and rotator cuff arthropathy are conditions that can lead to these symptoms as well.
X-rays of the shoulder can aid in the diagnosis of arthritis by showing a decrease in joint space, bone degeneration, and spurring.
Anti-inflammatory medications, ice or heat, and cortisone injection therapy can be very beneficial for patients with arthritis. Therapy is typically not beneficial.
In some cases, patients with mild arthritis can benefit from arthroscopic surgery to clean out the joint and remove spurs.
If you have isolated arthritis at the end of your collarbone or acromio-clavicular joint¬, you may be a candidate for an arthroscopic procedure as well. Using tiny incisions and a camera, the surgeon can remove the end of the clavicle and increase the AC joint space.
Patients with advanced arthritis who do not respond to conservative treatment may require a larger, open procedure to alleviate pain. Shoulder replacement surgery removes the damaged bone and replaces it with artificial prosthesis. Types of shoulder replacement surgery are:
- Hemiarthroplasty (partial replacement): The damaged humeral is replaced with a metal prosthesis. The glenoid, or socket, is not replaced.
- Total shoulder arthroplasty (total replacement): When both the ball and socket are worn, the surgeon may replace the worn humeral head with a metal implant and the socket is replaced with a plastic cup.
- Reverse total shoulder arthroplasty (total replacement): When the rotator cuff is not functioning or intact, a traditional shoulder replacement will not work because the body relies on different muscles to control the arm. In a reverse total shoulder replacement, the humeral head is replaced with a “socket” type implant and the glenoid(cup) is fitted with a ball implant.