Osteoarthritis

Generally

Shoulder osteoarthritis is a condition that can significantly impact patient’s daily routine, as it is accompanied by pain and limited movement of the shoulder joint.

The final and effective treatment of osteoarthritis, which allows the patient to return to a normal life, is total shoulder arthroplasty and replacement of the affected joint surfaces, with special implants.

What is a shoulder joint?

When we talk about the shoulder joint, we mean the glenohumeral joint, which consists of two articular surfaces: head of the Humerus and the glenoid cavity of the shoulder blade.

What is shoulder osteoarthritis?

Shoulder osteoarthritis is the wear of the articular surfaces of the shoulder joint. It is a degenerative disease, i.e. the probability of its occurrence increases with age.

How many years of experience does Dr. Pantos have in this particular method?

Dr. Pantos has many years of training and experience in specialized shoulder surgery centers in Germany.

What kind of implants will you use?

In total arthroplasty of the shoulder joint there is the option of placing metal, ceramic or polyethylene implants.

What type of anesthesia will I receive?

Total arthroplasty of the shoulder joint is performed under general anesthesia.

How many days will I be hospitalized?

The patient remains in the hospital for 1 to 2 days and then returns home.

When will I return to my daily activities?

The return to daily activities is gradual and begins as early as one week after surgery. It is noted that the patient can self-serve even three days after surgery.

What is the success rate of this surgical method?

The success rates of total arthroplasty in the shoulder joint are very high and range between 90% to 95%.

Shoulder osteoarthritis can be divided into two general categories depending on its causes:

The first category concerns primary osteoarthritis, which has unspecified causes. Scientists attribute it to a genetic predisposition combined with chronic strain.

The second category concerns secondary arthritis, which may be caused by an injury to the shoulder area, a tendon rupture or, more rarely, an infection.

Another cause of osteoarthritis is the so-called osteonecrosis of the head of the humerus. This condition is not as rare as people think and causes, what is stated by its name, the death (necrosis) of the head of the humerus. Osteonecrosis occurs in cases of chronic alcoholism, chronic use of cortisone, etc.

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Symptoms

What are the symptoms of shoulder osteoarthritis?

Initially there is pain that gradually escalates and is accompanied by limitation of shoulder movement/joint stiffness. Afterwards, the pain worsens with the various movements of the shoulder, such as rotation or abduction, and as a result the patient eventually protects/avoids the use of the upper limb due to pain. In the final stages of the disease, crackle appears as the bones rub against each other. At this stage, there is no other treatment for osteoarthritis than surgery.

Diagnosis

How is osteoarthritis of the shoulder diagnosed?

In most cases, a simple x-ray of the joint on two levels is sufficient, when joint space narrowing is observed as well as the appearance of osteophytes (that is, the formation of new bone, in places that normally should not exist). MRI is often useful, regarding the diagnosis, in order to choose the appropriate treatment.

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Treatment

How is shoulder osteoarthritis treated?

In the early stages of shoulder osteoarthritis, conservative treatment is recommended, which aims to reduce pain, maintain mobility and strengthen muscles.

Conservative treatment consists of physical therapy, administration of anti-inflammatory and analgesic drugs for a limited period as well as injections of hyaluronic acid and growth factors.

It should be noted that the above treatment does not cure the disease, but simply relieves the pain and delays its progression.

The final and effective treatment for shoulder osteoarthritis is total joint arthroplasty with the replacement of the affected joint surfaces with special implants.

Are there different surgical approaches?

When the tendons are intact, then the anatomical total arthroplasty is chosen, while in case of a massive rupture of the tendons, reverse total arthroplasty is used.

Particularly:

Anatomical: is the replacement of problematic joint surfaces with metal or polyethylene implants one by one.

Reverse: is the operation during which we reverse the articular surfaces (glenoid cavity of the shoulder blade and head of the humerus). We do this so as to use the muscles of the shoulder area for the movement, as the tendons, which are responsible for shoulder movement, are ruptured.

The length of the incision made in both operations is 8-10 cm, while the lifespan of the implants exceeds 15 years.

The rates for a new surgery are just 5% within the first 10 years after the initial surgery.

Which surgical method is better and safer for me?

Total arthroplasty of the shoulder joint is a surgery of very low risk.

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