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 arthritis, psoriatic arthritis, lupus, gout, ankylosing spondylitis, crystal deposition disease, Reiter's, lyme disease, juvenile arthritis, infectious (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 (chondrolysis, post-arthroscopic glenohumeral chondrolysis, capsulorrhaphy 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.

Follow on twitter: https://twitter.com/shoulderarth
Follow on facebook: click on this link
Follow on facebook: https://www.facebook.com/frederick.matsen
Follow on LinkedIn: https://www.linkedin.com/in/rick-matsen-88b1a8133/

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).

Postoperative chondrolysis after intra-articular pain pump infusion of an anesthetic medication - now in the knee as well as the shoulder. JBJS

Previous posts on this blog from 3/25/11, 4/7/11, 10/1/11, 11/3/11, 11/9/11, 11/10/11, 11/29/11, 12/31/11, 1/23/12, 2/18/12 and 4/11/12 have dealt with the development of postoperative glenohumeral chondrolysis after intra-articular pain pump infusion of an anesthetic medication.

The JBJS recently published an article regarding the same complication of pain pumps when used in the knee: "The Development of Postoperative Knee Chondrolysis After Intra-Articular Pain Pump Infusion of an Anesthetic Medication: A Series of Twenty-One Cases". 

In each of 17 knees in this most recent report, 0.5% bupivacaine was infused and in one 0.25% bupivacaine was infused.

This article provides additional independent evidence supporting the causation of chondrolysis by pain pumps, even though this causational relationship has been termed 'speculative' by some authors.

--

If you have suggestions for topics you'd like us to address in this blog, please send an email to

shoulderarthritis@uw.edu.

Use the "Search the Blog" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty,  and rotator cuff surgery.

See the countries from which our readers come on this post.