Osteoarthritis can occur in the shoulder as a result of an injury or a degenerative process that comes with aging. This is usually associated with wearing away of the once smooth cartilage surface to reveal the underlying bone and is often associated with pain and stiffness in the shoulder. These mechanical changes are also accompanied by biologic and chemical changes within the joint that are usually not reversible.
The process of arthritis cannot be reversed but there are treatments available that are designed to decrease the pain and stiffness that comes with this disease. Arthritis of the shoulder can be treated a number of ways. Typically, for mild cases, patients are given oral anti-inflammatory medications and a physical therapy program aimed at strengthening the surrounding muscles. Steroids or joint fluid supplements can also be injected into the shoulder in an effort to decrease symptoms.
Surgical intervention for arthritis of the shoulder has historically been limited to joint replacement which removes the painful and diseased areas of the shoulder, replacing them with metal and plastic bearings. However, in patients that would like to prolong the use of their native shoulder before having a replacement, there is an arthroscopic alternative that aims to remove scar tissue and decrease pain. This surgery involves using small incisions and a small camera to remove loose pieces of cartilage and “clean up” the joint. The surgery also usually includes a release of the capsule as well as removal of the joint lining, which is a source of pain and is often inflamed. In some cases, microfracture is used to attempt to restore areas of degenerated cartilage. The microfracture procedure involves making tiny holes in the bone that releases healing elements in the area of cartilage loss. This blood fills the defect and turns into scar tissue that behaves like cartilage.
Following surgery, Dr. Anz will arrange for a physical therapy program that helps restore motion and increase the strength of the muscles that stabilize the shoulder. Patients will often benefit from the use of the sling in the early weeks following surgery. Patients are allowed to eventually return to activities with a progressive return to shoulder function.
For additional information on the treatment for osteoarthritis of the shoulder, or for further resources concerning joint preservation and cartilage restoration, please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute.