Arthritis of the shoulder joint:
Arthritis of the joint is very common disease and almost everybody off us would have arthritis in his joint at some stage of his life. However the shoulder joint is not very popular to be involved in arthritis compared with the hip and knee joints.
Arthritis in general terms means destruction of the article of surfaces as a result of inflammation of the joints due to inflammatory arthritis or due to osteoarthritis which is the wear and tear type of arthritis.
The shoulder joint is a ball and socket joint which is very mobile to allow motion in different directions. The acromioclavicular joint is the small joints between the end of the clavicle in the top of the acromion which can also be affected by arthritis.
Most of the arthritis involving the shoulder are related to rheumatoid which is an inflammatory reaction causing destruction of the articular surfaces. Arthritis in the shoulder can also be as a result of trauma and called the post traumatic arthritis and can also be caused due to deficiencies in the rotator cuff which changes the bio-dynamics of the shoulder joint and causing what is called rotator cuff tear arthropathy. Primary Osteoarthritis and osteonecrosis are another causes.
Pain and restricted range of motion are the main symptoms related to arthritis of the shoulder. The clinical examination reveal tenderness, swelling, and restricted range of motion particularly in external rotation and abduction. X-ray of the shoulder would reveal signs of arthritis including decreased joint to space and irregularities around the joint including osteophytes and cyst formation.
Treatment of the shoulder arthritis would depend on the stage of the disease and level of symptoms. In almost all cases Conservative Management should be tried including anti-inflammatory medication, physiotherapy, joints injection with steroids, PRP, or stem cells.
In case of advanced arthritic changes causing significant pain and restriction of motion, surgical treatment would be indicated and it is mostly in the form of shoulder replacement surgery which is a ball and socket joint or with a reverse shoulder joint replacement which is used in cases of rotator cuff deficiencies and an elderly population.
The result of the surgical treatment is generally very good reducing the pain and gaining better range of motion although patient should not expect full range of motion in the shoulder after replacement surgery. The procedure carry very little risk of complication in experienced hands particularly with the new generation of a prosthesis and advanced surgical technique.