The cartilage that surrounds our bones is constantly renewing itself; osteoarthritis of the shoulder occurs when this phenomenon is disrupted, and the cartilage is destroyed more quickly than it can rebuild itself. Since the function of this non-innervated (not supplied by nerves) protective layer is to enable the joint surfaces to slide painlessly, allowing the shoulder to move, cartilage degeneration leads to painful friction between the highly innervated bones (supplied by lots of nerves), and the formation of bony growths (osteophytes*An abnormal bony growth that generally develops around a joint suffering from osteoarthritis.).
Symptoms of Osteoarthritis of the Shoulder
Osteoarthritis of the Shoulder is characterized by pain that initially occurs only when the joint is used, but later becomes nearly permanent. Loss of mobility, pain, and crackling in the joint are the main symptoms experienced by people with osteoarthritis of the shoulder. Over time, this functional discomfort may considerably affect quality of life and represent a serious handicap in everyday life.
Causes of Osteoarthritis of the Shoulder
Centered osteoarthritis of the shoulder is a primary form of arthritis, which means that its cause has not been identified. It may be a natural consequence of the joint aging. The tendons are generally preserved. It does not create any imbalance, and the osteoarthritis remains centered.
Osteoarthritis of the shoulder is considered to be secondary if it is the result of an identified condition. This includes dislocations*An injury that occurs when the joint surfaces come away from one another. It is commonly referred to as a dislocated shoulder. fractures, an infection, a rheumatoid disease (in which case the term arthritis is used rather than osteoarthritis), or a tendon tear (called the rotator cuff*Fibrous connective tissue that links muscles to bone.). In the latter, the torn tendons lead to an imbalance in the shoulder (eccentric osteoarthritis).
Treating Osteoarthritis of the Shoulder
The main aim of osteoarthritis of the shoulder treatment is to relieve the symptoms. Resting the shoulder, physiotherapy sessions, pain killers, anti-inflammatories, and/or injections (for example of anti-inflammatories, or a synovial fluid replacement) may be prescribed as a first line treatment. They are not normally enough to halt the development of the osteoarthritis. When the disease affects a person’s quality of life, replacing the joint with a prosthesis is considered.
Surgery for osteoarthritis of the shoulder consists of replacing the worn parts of the joint with prosthetic implants to reduce the painful friction and restore mobility to the joint.
Shoulder prostheses have been around for over 50 years. Several models are available depending on the case and criteria such as the nature and stage of the disease, and the patient’s age and health. The operation is not contraindicated for reasons of age as having a good quality of life is always important. People over the age of 80 can therefore have a joint replacement if they are experiencing significant painful symptoms.
There are two types of prosthesis: anatomic and reverse. Anatomic prostheses are made of two parts that recreate the anatomy of the humerus and the shoulder blade, and are used if the shoulder tendons (rotator cuff) are not too badly damaged. If these tendons are too badly damaged, a reverse prosthesis is used, which provides its own stability enabling it to function despite a tear in the tendons and muscles of the rotator cuff.
Progression and Possible Complications
Osteoarthritis of the shoulder often progresses slowly with outbreaks of inflammation accompanied by an intensification of the pain. Without treatment, they can become more and more frequent and can stop the person from sleeping. Some rare cases of osteoarthritis of the shoulder are destructive and progress rapidly.
The operation to replace the damaged joint with a prosthesis is not totally without risk. Although such risks are rare, they must be taking into account when making a decision. They include the risk of bruising, incomplete recovery of the range of motion in the joint, and post-operative fracture. Infection can be a problem, but is luckily rare.
Care at Hôpital de La Tour
Your care will begin with a clinical examination to check the mobility in your shoulder. Medical imaging technologies (X-ray*A medical imaging technique performed using X-rays., CT*A medical imaging technique used to see bones. It is used to create a 3D reconstruction of the shoulder, the virtual fitting of the prosthesis, and to determine the ideal position and the most suitable design., MRI*A medical imaging technique used to obtain information about the state of the tendons, ligaments, and cartilage.), ) are used to diagnose osteoarthritis of the shoulder, assess the amount of joint damage, and determine whether there are any associated injuries (a tendon tear in particular). This diagnosis will be made by a rheumatologist, a sports physician or a shoulder surgeon.