Arthritis – Shoulder Osteoarthritis

Osteoarthritis of the shoulder is a condition that can significantly encumbers the patient’s daily life, as it is accompanied by pain and limitation of movement of the shoulder joint. The final and effective treatment of osteoarthritis, which allows the patient to return to a normal life, is surgically performed with total arthroplasty and replacement of the affected joint surfaces with special implants.
Shoulder Joint – What It Is When we talk about the shoulder joint, we mean the shoulder blade joint, which consists of two articular surfaces: the head of the humerus and the shoulder blade.

Shoulder osteoarthritis is the tear of the articular surfaces of the shoulder joint. It is a degenerative condition, that is, with age, the likelihood of its occurrence, increases.
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 stress.

The second category concerns secondary arthritis, which can be due to a trauma in the shoulder area, a ruptured tendon or more rarely an infection.

Another cause of osteoarthritis is the so-called, osteonecrosis of the head of the humeral bone. This condition, not as rare as people think, causes the head of the humerus to die. Osteonecrosis occurs in cases of chronic alcoholism, chronic cortisone use, etc.

Initially, pains occur that gradually escalate and are accompanied by limitation of shoulder movement / joint stiffness. The pain then, gets worse during the various movements of the shoulder, such as turning or abducting, with the result that the patient eventually protects/avoids the use of the upper limb precisely because of the pain. In the final stages of the disease, trembling occurs, as the bones rub against each other. At this stage, there is no other treatment for osteoarthritis than surgical treatment.

In the majority of cases, a simple X-ray of the joint in two levels is sufficient, where the reduction of the articular space and the appearance of osteophytes (i.e., the creation of new bone, in positions that normally should not exist) are observed. MRI is often useful in the context of diagnosis to choose the appropriate treatment.

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

Conservative treatment consists of physiotherapy, administration of anti-inflammatory and painkillers for a limited period of time, as well as, injections of hyaluronic acid.

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 of osteoarthritis of the shoulder is total arthroplasty of the joint, replacing the affected articular surfaces with special implants.

When the tendons are intact, then anatomical total arthroplasty is chosen, while when there is a massive rupture of the tendons, reverse total arthroplasty is used. Especially:
Anatomical is, the replacement of problematic joint surfaces with metal or polyethylene implants, one by one.

Inverse surgery is the operation in which we reverse the articular surfaces (shoulder blade and humeral head). This is done in order to take advantage of the muscles of the area for the movement of the shoulder, as the tendons which are also the natural responsible for the movement of the shoulder, have been torn.

The incision made, in both operations, is 8-10 centimeters long, while the lifespan of the prostheses exceeds 15 years.