Shoulder osteoarthritis, chondrolysis, rheumatoid arthritis, degenerative joint disease, and arthritis after shoulder arthroscopy and open surgery

Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Saturday, July 05, 2008

Figure 1 - This is a humeral head in situ that has been damaged by arthritis.

Figure 2 - Humeral implant

Summary

What are the key points about shoulder replacement surgery for shoulder arthritis?

Diagnosis and treatment of shoulder arthritis

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In shoulder arthritis, the smooth cartilage that normally covers the surfaces of the ball (humeral head) and socket (glenoid) is lost. The result is that there is bone on bone rubbing between these two joint surfaces.
This bone-on-bone contact produces pain, stiffness, difficulty sleeping and the inability to do activities of daily living, work and sports.

Shoulder arthritis may result from wear and tear, osteoarthritis, rheumatoid arthritis, rotator cuff tears or may follow surgery for recurrent dislocations.

Chondrolysis is a severe type of shoulder arthritis in which the cartilage of the joint is abruptly lost. It has been noted to follow shoulder arthroscopy. While the cause is not known, chondrolysis may be associated with the use radiofrequency heat to shrink the shoulder capsule and the use of pain pump catheters placed in the joint after surgery for post-operative administration of local anesthetic, such as Marcaine (bupivacaine) or Xylocaine (lidocaine) and epinephrine.

Treatment of shoulder arthritis may include exercises , a ream and run procedure, or a total shoulder.

After performing a clinical exam and x-rays, a shoulder surgeon experienced in joint replacement can find out if arthritis is the cause of the problem and if surgery would be helpful. Patients are most likely to benefit from this surgery if they are well motivated and in good health.

The goal of shoulder replacement arthroplasty is to restore the best possible function to the joint by removing scar tissue, balancing muscles, and replacing the destroyed joint surfaces with artificial ones.

Total shoulder joint replacement arthroplasty is a highly technical procedure and is best performed by a surgical team who performs this surgery often. Such a team can maximize the benefit and minimize the risks. The two-hour procedure is performed under general (or nerve block) anesthesia.

• Lowell North sails away with new shoulder (uwnews.org)

• JBJS Article on Total Shoulder Arthroplasty (PDF) (0.8 MB)

• JBJS Article on Hemiarthroplasty (PDF) (0.16 MB)

• JBJS Article on Total Shoulder Technique (PDF) (1.20 MB)

• JBJS Article on Total Shoulder Result (PDF) (0.14 MB)

Streaming video
Dr. Matsen and Sarah Jackins, physical therapist with the UW Bone and Joint Surgery Center, discuss shoulder surgery with an emphasis on patient involvement in the UWTV video, "Total Shoulder Replacement: Partnership with the Patient".

Surgery for shoulder arthritis at the University of Washington

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