Glenohumeral (shoulder) arthritis occurs when the protective cartilage on the surface of the glenoid (socket of the shoulder joint) and the humeral head (ball of the shoulder joint of the upper arm) wears out. As a result, shoulder pain and limitations can occur as the worn ends of the bones in the joint grind together, deform, and cause inflammation.
What Is Glenohumeral Arthritis?
The glenohumeral joint is the ball-and-socket joint of the shoulder, consisting of the humeral head (ball) and the glenoid (socket). The protective cartilage covering these joint surfaces can break down from genetic susceptibility, excessive joint loading over time, systemic disease, or following an injury.
As the cartilage wears out, the worn ends of the bones can grind together, causing inflammation, pain, and physical limitations.
Glenohumeral arthritis takes several forms:
- Primary osteoarthritis: age-related wear, typically in patients over 60
- Post-traumatic arthritis: after a prior fracture, dislocation, or surgery
- Rotator cuff arthropathy: arthritis that develops after a massive, untreated rotator cuff tear, with the humeral head riding high against the acromion
- Inflammatory arthritis: from rheumatoid arthritis or related conditions
- Avascular necrosis: loss of blood supply to the humeral head, leading to collapse and secondary arthritis
Causes and Risk Factors
- Previous injury to the glenohumeral joint that results in premature wearing of the protective cartilage
- Heavy and/or repetitive loading of the joint, such as with weight lifting or heavy labor
- Genetic susceptibility or a family history of arthritis
- Inflammatory or autoimmune diseases that damage articular cartilage, such as rheumatoid arthritis
- Other systemic disease-related arthritis
- Previous shoulder surgery and persistent decreased range of motion
- Large chronic rotator cuff tears
Symptoms
- Shoulder pain, weakness, and decreased range of motion
- Shoulder pain that worsens with activity
- Shoulder stiffness that is worse in the morning or with lack of activity
- Pain at night that affects sleep due to activity during the day
Treatment
Initial treatment consists of activity modification, including stopping aggravating activities, as well as rest, ice, and anti-inflammatory medications to relieve pain. Specific physical therapy programs and injections can help reduce inflammation and pain and improve motion and function.
Surgery is not required even if symptoms continue despite conservative treatment. The condition does not progress rapidly, and surgery can usually be performed when the patient decides symptoms are sufficient to undergo surgery. In rare cases, extreme loss of shoulder motion and erosion of the glenoid (socket of the shoulder joint) may call for earlier intervention and surgery.
When symptoms warrant, Dr. Chudik can replace the damaged and arthritic joint surfaces of the shoulder. Shoulders with a compromised or chronically torn and irreparable rotator cuff or severe deformity may require a reverse shoulder replacement.
Recovery and Outcomes
Shoulder replacement surgery is generally well-tolerated and often performed as an outpatient, allowing the patient to return home the same day.
A sling is worn for six weeks before active shoulder motion begins. Physical therapy begins two to three days following surgery to restore shoulder range of motion while protecting the repaired rotator cuff portion of the shoulder.
For patients with symptomatic glenohumeral shoulder arthritis that does not respond to conservative treatment, surgery to replace the damaged surfaces of the shoulder joint can eliminate pain and allow an improved functional recovery.
When to See Dr. Chudik
Schedule an evaluation if shoulder pain and stiffness are interfering with sleep, work, or daily activity, or if prior treatment no longer controls symptoms. Call 630-324-0402, email contactus@chudikmd.com, or request an appointment online.