Shoulder Arthritis

The shoulder is a complex ball and socket joint. It is made up of the humerus (upper arm), scapula (shoulder blade), and clavicle (collarbone). The humeral head rotates on a portion of the scapula (glenoid) with a curved surface through range of motion. The rotator cuff tendons and a variety of ligament and cartilage structures aid in shoulder stability.

Arthritis is a loss of cartilage in a joint resulting in pain and inflammation. It may occur due to aging, trauma, or a variety of medical conditions. Arthritis in the shoulder most commonly results from osteoarthritis, rheumatoid arthritis (RA), posttraumatic arthritis, cuff tear arthropathy (arthritis after a long-standing rotator cuff tendon tear), and avascular necrosis (AVN).

Shoulder arthritis symptoms most commonly include pain with use, difficulty or limited motion, and a grinding sensation.

Evaluation of shoulder arthritis begins with a history of symptoms and treatment, physical examination, and x-rays. An MRI may be done to evaluate the quality of the rotator cuff or a CT scan may be done to evaluate the quality of the bone in the glenoid.

The goals of treatment are to reduce pain and increase use. Initial treatment begins with the use of anti-inflammatory medications and physical therapy. Activity modification, moist heat and/or ice may also be used. Corticosteroid injections may also be used in those with continued symptoms.

Surgical treatment reserved for those to continue to have symptoms despite the above treatment. Surgical treatment is dependent on the extent of arthritis. Arthroscopic surgery to debride the damaged cartilage or labrum is an option for patients with mild arthritis. Shoulder replacement is recommended in those with moderate to advanced arthritis. This is done by replacing the surfaces with artificial components. There are a variety of replacement options and much of it is dependent on age, activity, type and extent of arthritis, and the quality of the rotator cuff. Options include resurfacing, hemiarthroplasty, total shoulder arthroplasty, and reverse shoulder arthroplasty.