The most common arthritis in the shoulder is osteoarthritis. It is a degenerative joint disease in which the cartilage that covers the ends of bones in the joint deteriorates, causing pain and loss of movement as bone begins to rub against bone. It is the most prevalent form of arthritis.
The most common cause is recurrent dislocation of the shoulder, which causes damage to the smooth cartilage covering the arm bone and socket. This repetitive trauma over years can cause the cartilage to die and fall off.
Heavy weight lifting over many years, especially bench press can cause wear at the back portion of the shoulder joint.
Trauma due to a fall on the arm can knock cartilage off or interrupt the blood supply to the cartilage and cause arthritis later on in life.
A tear in the rotator cuff tendon will get larger in size if not fixed and allow the arm bone to move up and down in the socket rubbing the smooth cartilage off the bone.
- Pain with all motions of shoulder
- Aching pain at night and difficulty sleeping due to pain
- Grinding in the shoulder
- Progressive stiffness in shoulder, worse in the morning
- Pain in the front or back of shoulder
X-rays, symptoms and physical exam make the diagnosis. Early arthritis, which may not be seen on x-ray, can sometimes be seen on MRI, although in very early cases the MRI may be negative.
Conservative treatment consists of rest or change activities to avoid provoking pain; the individual may need to modify the way he or she moves the arm to do things. Anti-inflammatories, Glucosamine Chondroitin, icing shoulder 2-3 times a day to reduce swelling and pain, physical therapy to regain motion, or cortisone injections if pain is severe. In early arthritis lubricant injections can be helpful, but do not work well when the joint is bone on bone.
Surgical treatment consists of arthroscopy with removal of loose cartilage and possible stabilizing of the joint, if dislocation is the cause for the early arthritis. Other surgical treatment if the shoulder is stiff is arthroscopy and manipulation to regain range of motion. These treatments will not help if the arthritis is severe with bone rubbing on bone. The treatment of severe arthritis is a Shoulder Joint Replacement.
Joint resurfacing is an alternative to total joint replacement surgery. It is a surgical procedure that allows patients to retain much of their natural tissue, by replacing only the diseased part of the joint instead of the entire joint. This gradual approach to surgery means the patient may still be able to have a total joint replacement later if necessary.
The Resurfacing Humeral Head Implant is for patients with arthritis, rheumatoid arthritis or humeral head fractures. It is an option for younger, more active patients who might otherwise postpone surgery.