Jan 21, 2011

What Is Glenohumeral Arthritis and How Can It Be Treated?

Simon Moyes explains what Glenohumeral Arthritis is and how to treat it.

Glenohumeral arthritis is a degenerative condition affecting the glenohumeral cartilage of the shoulder.
Both joints in the shoulder (the glenohumeral and the AC joint) can be affected by arthritis and share common symptoms.

AC [acromio-clavicular] arthritis involves the small joint between the outer end of the collar bone and shoulder blade. Pain is well localized to this area and normally occurs when the arm is being used well above shoulder height.

Glenohumeral arthritis is not as common as traditional arthritis in weight bearing joints (hip or knee), but is mostly found in patients over the age of 60.

As our bodies age, the smooth surface of the cartilage (the connective tissue that protects the bones in the joints and allows movement), wears down and becomes rough.

Over time, the bones can become exposed and rub against each other, as they increasingly lack the protection of the cartilage. It is this rubbing that can deform or disable the joint, limiting the motion of the arm and cause a great deal of pain.

Patients with glenohumeral arthritis will typically feel tenderness and pain in the upper arm and shoulder, and in a few cases the forearm, chest and neck. Consequently, motion in the shoulder may become limited while movements involving the compressing of the joint, such as reaching the arm across the chest, will cause a great deal of pain.

The shoulder may appear larger than usual and be prone to clicking or snapping as it moves. Swelling in the joint may also develop, limiting the patient’s ability to perform everyday tasks such as reaching up high.

Initially, the first forms of treatment are anti-inflammatories, painkillers, gentle exercising and resting the shoulder.

Application of ice to the area will also decrease pain and inflammation. Cortico-steroids can be injected directly into the joint if the pain persists.

In some cases, physiotherapy and ultrasound may be used to reduce pain and stiffness.

Arthritic changes affecting the glenohumeral joint are relatively uncommon. In such cases, it is important to establish the integrity of the rotator cuff. Cuff tear arthropathy (CTA) requires specific treatment to ensure restoration of movement.

Conservative management includes analgesia, physiotherapy and activity modification, steroid injections can also be used.

Arthroscopy can be used to examine the interior of the joint to determine the damage to tendons, ligaments and cartilage. It is also used therapeutically to debride the joint.

Sometimes surgical reconstruction may be necessary, the most common procedure being Arthroplasty, which is a shoulder replacement. A shoulder replacement involves prosthetic surfaces being used to rebuild the joint.

Simon Moyes is an internationally renowned orthopaedic surgeon. His Capital Orthopaedics team works at Basinghall Clinic in London, with its state-of-the-art diagnostic and surgical equipment, and top sports medicine professionals. Contact Simon Moyes for an expert diagnosis and treatment of shoulder injuries.

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The Capital Orthopaedics team is made up of highly experienced medical professionals – from Mr Simon Moyes, the renowned orthopaedic consultant surgeon, to physicians, nurses, anaesthetists and physiotherapists.
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