Yasmin Dhar, M.D.
Orthopedic Surgeon and Sports Medicine Specialist
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What is shoulder arthritis?
Osteoarthritis of the shoulder, as known as degenerative joint disease, occurs when the articular cartilage covering the bones degenerates or wears over time causing swelling of the joint and pain. Usually, shoulder arthritis occurs in older patients over the age of 50-60, but it may occur in younger patients after injury or trauma.
What are the symptoms and how do you diagnose shoulder arthritis?
The most common symptom of shoulder arthritis is pain. Limited range of motion with clicking or crunching may also occur when moving the shoulder. A physical examination to assess your range of motion and x-rays to evaluate the extent of your arthritis should be performed. Depending on your symptoms, an MRI or lab tests may be warranted.
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to learn more about shoulder injuries,
disorders and treatment options
How do you treat shoulder arthritis?
There are many conservative treatments for shoulder arthritis. Anti-inflammatory medication, heat, ice, physical therapy, stretching exercises and dietary supplements (i.e. glucosamine and chondroitin) may all be used as initial treatment for your shoulder arthritis. A cortisone injection may also help improve the pain and, in conjunction with physical therapy, gain more motion.
If nonsurgical options do not work effectively, there are surgical options mostly involving replacing the shoulder joint with metal and plastic implants. A shoulder joint replacement (called total shoulder arthroplasty) replaces the whole shoulder, both the “ball” and “socket”, with an artificial joint. Humeral head replacement (called hemiarthroplasty) replaces just the “ball” portion of the shoulder and leaves the socket intact. These two options work best for patients with arthritis with an intact rotator cuff to maintain the normal mechanics of the shoulder.
Rotator cuff arthropathy is arthritis of the shoulder secondary to chronic, irreparable tears in the rotator cuff. Over time, without the rotator cuff to maintain the humeral head aligned with the glenoid, the humeral head migrates superiorly causing pain, loss of motion and arthritis. Those people with significant pain and loss of motion, who have not improved with nonsurgical options, are candidates for a reverse total shoulder replacement.
In a healthy shoulder, the rotator cuff muscles position and power the arm in different degrees of motion. A conventional shoulder replacement uses the rotator cuff muscles to function properly. In a patient with rotator cuff arthropathy, these muscles no longer function. Instead, the reverse total shoulder replacement relies on the deltoid muscle to power and position the arm. Generally, reverse shoulder replacement surgery is indicated for older, low demand patients with arthritis and irreparable chronic rotator cuff tears and a functioning deltoid seeking improvement in pain and motion in the shoulder.