Shoulder Arthritis

Introduction

Shoulder arthritis is the progressive wearing down of the shoulder ball and socket joint.

There are different types of arthritis that can affect the shoulder. These include:

  • Osteoarthritis  - a condition that destroys the smooth outer coverage of bone and cartilage in the shoulder joint.
  • Rheumatoid arthritis - a condition causing the lining of the shoulder joint to swell.
  • Post-traumatic arthritis – a condition that develops after an injury such as a break or dislocation.
  • Avascular necrosis – a condition affecting the blood supply causing the bone cells to die. 

Symptoms

  • Gradual shoulder stiffness and pain
  • Limited range of motion in the shoulder
  • Night pain is common in the shoulder

Investigation

  • Physical examination
  • X-ray
  • Ultrasound scan
  • MRI scan
  • CT scan

Shoulder arthritis develops very slowly and can cause only mild symptoms. Surgical solutions are only considered when discomfort and stiffness becomes intrusive and extremely painful.

Nonsurgical Treatment

  • Painkillers
  • Anti-inflammatory drugs
  • Physiotherapy
  • Ice packs
  • Steroid injections
  • Rest

Surgical Treatment

  • Arthroscopy

The consultant inserts a small camera (an arthroscope) into the shoulder joint. The camera displays pictures on a television screen enabling the surgeon to guide miniature surgical instruments in the shoulder. The operation will clean out the inside of the joint.

  • Shoulder replacement

Surface replacement – removes a small portion of the patient’s bone and replaces the head of the humeral (upper arm) bone.

Total replacement – involves replacing both the ball and socket part of the joint with a metal ball on a stick that fits into the humeral (upper arm) bone. A plastic cup is also fixed.

Reverse polarity replacement – performed only when there is both arthritis and a big rotator cuff tear which cannot be repaired. During the operation the ball and socket are reversed, the cup goes on the end of the arm bone and the ball is attached to the shoulder blade.

Shoulder replacements are very successful and provide good results. They eliminate and reduce pain and discomfort. However, it will never be a full recovery despite having physiotherapy.

Rehabilitation aims to restore the range of motion and power of the arm.

Physiotherapy will vary depending on the type of procedure performed.