Shoulder arthritis treatments
Nonsurgical treatment of osteoarthritis
Osteoarthritis of the shoulder is generally better tolerated than osteoarthritis of the hip or knee. It can cause a certain amount of pain or a slight loss of range of motion. Nonsurgical treatment is therefore the treatment of choice:
- preventive restriction of activities
- oral anti-inflammatories
- steroid or viscosupplement injection
Despite numerous studies on the subject (in particular on glucosamine sulfate), as yet there is unfortunately no nutrient with scientifically demonstrated effectiveness in treating osteoarthritis.
Platelet rich plasma (PRP) and stems cells (or more accurately MSC cells) injections have been advocated as new treatments, but the medical evidence of their use is very scarce, and they should be recognized as experimental.
When should surgery for osteoarthritis of the shoulder (glenohumeral joint) be considered?
Surgery may be necessary if the problems related to the pain can no longer be managed by the nonsurgical measures mentioned above.
Arthroscopic debridement surgery may be considered in some cases if the osteoarthritis is mild or if the main problem is synovitis.
In advanced osteoarthritis with cartilage destruction or a bone deformity, the best surgical treatment is artificial joint replacement. In some cases, replacement of the humeral head by resurfacing is sufficient and the glenoid-scapula component does not have to be replaced.
In other cases, total shoulder joint replacement (humeral component and glenoid component) is indicated. This surgery has been performed for around twenty years: pain control and improved function are seen in 90% of cases. It is a major intervention with risks and complications:
- Nerve damage
- Vascular damage
- Shoulder weakness
- Permanent stiffness
These treatments also require a lengthy convalescence of 6 to 12 months.
It is also important to know that after a total shoulder joint replacement, the prosthesis itself has a useful lifespan of about 15 to 20 years. We should point out that the main benefit of successful surgery is pain relief and not the complete restoration of range of motion, which is rarely achieved.
New type of “nonanatomical” or reverse prostheses (i.e., a ball attached to the scapula and a cup-shaped humerus) is now available. Even though this intervention carries a high risk of complications and is available only in very specialized hospitals, it is the best choice for patients suffering from chronic rotator cuff tear and advanced painful osteoarthritis.
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Five months after my operation, despite the severity of my wound, I am again able to ride a bike without difficulty or pain. I had an impeccable and attentive follow-up from Dr. Beauchamp. Thank you!