In a normal shoulder joint, the boney surfaces are covered with smooth cartilage. Together with a thin layer of fluid within the joint, this cartilage allows the bones to move to freely over one another. When the shoulder becomes arthritic, the cartilage gradually becomes worn, parts of it may break off and become loose within the joint, and more fluid may be produced as the body tries to compensate with extra lubrication.
Osteoarthritis is common and usually occurs later in life. Sometimes, if the joint has been damaged by trauma in the past, this type of arthritis can occur at a younger age.
Rheumatoid arthritis may also affect the shoulder. In this condition the body’s immune system mistakenly attacks the joints, and many joints may be involved at one time.
Signs and Symptoms
The most common symptoms of shoulder arthritis are pain and stiffness which gradually worsen over months and years. Many patients also experience grinding within the joint. Swelling, redness and deformity of the joint may occur. Overtime, the function of the joint becomes impaired so activities such as washing your hair become more difficult.
In addition to a discussion about your symptoms and an examination of your shoulder, Mr. Singh will arrange an X-ray. As can be seen from the X-rays above, this investigation may be enough to confirm the diagnosis. Sometimes a ultrasound scan or MRI is arranged to examine the rotator cuff and CT scan may be necessary to assess bone loss if surgery is being planned to allow careful and accurate positioning of components
Some patients achieve satisfactory pain control and improved shoulder function with regular painkillers, anti-inflammatories (and physiotherapy).
If the condition progresses and symptoms can no longer be controlled by the simple measures above, surgery will be considered. Possible procedures include:
• Arthroscopic Surgery – During this keyhole procedure, loose cartilage may be remove from the joint, the surface cartilage can be debrided (tidied up) and inflammatory tissue removed
• Surface Replacement – This is an open operation where the ball at the top of the arm bone (humeral head) is replaced.
• Shoulder Replacement – Here both the ball and the socket components of the joint are replaced.
Should an operation be advised, Mr. Singh will discuss all procedures in detail at your appointment.