Saturday, November 9, 2013

What is shoulder arthritis?

Definition of shoulder arthritis (glenohumeral arthritis)

The glenohumeral joint of the shoulder is where the ball of the humerus (arm bone) meets the glenoid socket of the scapula (shoulder blade). The surfaces of the glenohumeral joint are normally covered by smooth articular cartilage as shown for the surface of the humeral head below.




When two normal joint surfaces rub on each other, the friction is less than that of an ice skate on ice.


In most cases, a person's joint cartilage lasts their whole life long.

However, certain conditions can destroy the smooth functioning of the joint. The shoulder can be affected by different types of arthritis

The traditional dictionary definition of "arthritis" is "inflammation of a joint, usually accompanied by pain, swelling, and stiffness". This definition applies to conditions such as rheumatoid arthritispsoriatic arthritislupusgoutankylosing spondylitiscrystal deposition diseaseReiter'slyme diseasejuvenile arthritisinfectious (septic) arthritis, and Sjogren's in which inflammation of the joint lining, or synovium, forms a pannus which invades the articular cartilage normally covering the joint.

Today many of these conditions can be managed with medications before the cartilage is lost.


The more common types of 'arthritis' of the shoulder are not the result of inflammation at all, but rather represent the non-inflammatory loss of cartilage from wear (osteoarthritis (degenerative joint disease)) , injury (post traumatic arthritis), complications of surgery (chondrolysispost-arthroscopic glenohumeral chondrolysiscapsulorrhaphy arthropathy) or association with rotator cuff loss ( cuff tear arthropathy). 

In such cases, the cartilage is destroyed without inflammation, leaving a rough joint surface.





When the shoulder joint reaches this stage, the degree of loss can be seen on x-ray. If symptoms are limiting the quality of life and if gentle exercises are not effective, consideration can be given to a total shoulder replacement or, in selected cases, to a ream and run procedure. In rarer situations a reverse total shoulder or a CTA hemiarthroplasty may be the best choice. The role of surgeon experience is discussed here.

You can support cutting edge shoulder research that is leading to better care for patients with shoulder problems, click on this link.

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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).