Thursday, February 6, 2020

Shoulder arthritis - what is it?

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, ream and runreverse total shoulder, or a CTA arthroplasty depending on the specifics of the type of arthritis and the expectations of the patient.

To see a YouTube of our technique for total shoulder arthroplasty, click on this link.

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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