Shoulder Arthritis Treatment
If your struggle with shoulder pain caused by some form of arthritis, you deserve the best treatment possible. The team at OrthoBethesda provides Bethesda, Maryland, patients with high-quality orthopedic services to ensure you receive high-quality care. Our compassionate team will take the time to understand your condition fully.
Although we may initially recommend conservative treatment options, if you still struggle with joint pain, we may advise shoulder arthroscopy to provide relief for your severe symptoms and to help you regain mobility.
Negative Effects of Shoulder Arthritis
Shoulder arthritis, although much less common than knee or hip arthritis, has increased markedly in the past few decades with an aging population and increasingly active older population. Generally speaking, shoulder arthritis occurs at an older age than knee or hip arthritis. The shoulder is a ball and socket joint like the hip but with much less bone stock, no inherent stability and the greatest range of motion of any joint in the body. Like other areas of arthritis, the process is the loss of the articular cartilage that covers the joint surfaces and allows for smooth low friction movement between the ball and the socket of the joint. Arthritis can be divided into multiple groups including primary osteoarthritis (the most common type associated with aging), inflammatory arthritis (such as rheumatoid arthritis), rotator cuff arthroplasty (mechanical arthritis caused by the loss or dysfunction of the rotator cuff muscles), osteonecrosis and post-traumatic arthritis. All of these processes lead to a common end stage with the loss of the articular cartilage, increasing pain, decreasing range of motion and eventually deformity and loss of bone.
How Shoulder Arthritis is Treated
Many patients can be treated non-surgically. The modalities used include gentle physical therapy, use of non-steroidal anti-inflammatory drugs (NSAIDs), topical treatments such as lidocaine patches, and corticosteroid injections. All of these have a role in treatment and have provided varying levels of success albeit in most cases temporarily. Some patients will be able to remain functional with these treatments administered periodically indefinitely. Although there has been a great deal of discussion recently about the use of viscosupplementation (hyaluronic acid), platelet rich plasma and stem cell treatments, there is at this time very little scientific data to support their use.
For patients with unremitting pain not relieved by the above treatments, loss of sleep due to pain, inability to perform activities or increasing bone loss to the point that surgical options would be compromised, there is the option of shoulder replacement surgery. As in other joint replacement surgeries, some bone is removed from the shoulder joint and components made of metal and high-density polyethylene are inserted. The shoulder is unique from other joint replacements because of its much greater range of motion, flat unconstrained glenoid (shoulder socket) and dependence on soft tissues (muscle, tendon and ligaments) for proper functioning and stability. There are some situations when a shoulder replacement is contraindicated and this includes, infection, nerve damage around the shoulder, insufficient bone stock or loss of deltoid muscle function.
The preoperative planning involves appropriate x-rays of the shoulder in at least 2 planes to allow the determination of any loss of bone stock, orientation of the joint and presence of any bone abnormalities. At times, additional studies such as CAT scans and MRI scans are utilized to determine any damage to the rotator cuff tendons or other soft tissues and to further delineate bone damage. Routinely, computer sizing of the appropriate components are determined in advance of all procedures. For patients with significant deformity or bone loss, custom designed devices for determining the proper orientation of the components can be made and at times actual custom cad/cam (computer assisted design/computer assisted manufacturing) components are made specifically for the individual to fit their unique anatomy. All of these high-tech features are available and used when needed but there is no evidence to support their use in routine shoulder replacement cases.
*Some information excerpted from publications of the American Academy of Orthopedic Surgeons, the American Shoulder and Elbow Surgeons and Orthobullets.
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Contact OrthoBethesda to Find out More About Shoulder Arthroscopy
If you’re struggling with arthritis in your shoulder joint or unexplained pain, you can turn to Bethesda’s own OrthoBethesda. Our compassionate team utilizes cutting edge procedures, like shoulder arthroscopy, to ensure you receive the best diagnostic and surgical treatment available. Contact us today by calling (301) 530-1010 to make an appointment with one of our highly skilled surgeons. We look forward to treating you.