The most common problem leading to a shoulder replacement surgery is osteoarthritis, or “wear-and-tear” arthritis. Osteoarthritis can occur without any injury to the shoulder, but that is uncommon, because the shoulder is not a weight-bearing joint. Osteoarthritis caused by wear and tear is more common in the hip and knee. More commonly, osteoarthritis occurs many years after an injury to the shoulder. A shoulder dislocation can result in chronic instability of the shoulder joint. Repeated dislocations over many years damage the joint, leading to arthritis. Some fractures of the shoulder can also lead to arthritis.

Other types of arthritis affect the shoulder joint as well. Systemic diseases, such as rheumatoid arthritis, affect all the joints of the body. The result is much the same as osteoarthritis, making the shoulder painful and, therefore, difficult to use.

Symptoms

The symptoms of osteoarthritis of the shoulder are pain and reduced movement in the shoulder. The pain is typically aching in nature and can make it difficult to sleep. Certain movements may cause a grinding sensation or a catching sensation as the arthritic bone surfaces move against one another. Usually it is difficult to see any swelling in the shoulder joint because so much muscle covers it.

Diagnosis

The diagnosis of osteoarthritis of the shoulder begins with a complete history of the problem, followed by a physical examination of the shoulder. Your doctor will ask you about old injuries of the shoulder. A physical examination will be performed to try and determine how much strength and motion you have in the shoulder. Your doctor may look at other joints for other signs of systemic arthritis. X-rays of the shoulder will be necessary to make the diagnosis of osteoarthritis. X-rays will show the degree of changes in the bones of the shoulder and give some idea as to how much wear and tear is present. With your surgeon’s guidance, you’ll decide whether to consider joint replacement.

Degenerative problems may require replacement of the painful shoulder with an artificial shoulder replacement. The decision to proceed with surgery should be made jointly by you and your doctor only after you feel that you understand as much about the procedure as possible.

Once the decision to proceed with surgery is made, there are several things that may need to be done. Your orthopaedic surgeon may suggest a complete physical examination by your medical or family doctor. This is to ensure that you are in the best possible condition to undergo the operation. You may also need to spend time with the Physical Therapist who will be managing your rehabilitation after the surgery. The therapist will be able to begin the teaching process before the surgery to ensure that you are ready for the rehabilitation afterwards. The physical therapist will record a baseline of information. This includes measurements of your current pain levels, functional abilities, the available movement and strength of each shoulder. A second purpose of the preoperative visit is to prepare you for your upcoming surgery. You will begin to practice some of the exercises you will use just after surgery. Finally, an assessment will be made of any needs you may have at home once you’re released from the hospital. On the day of your surgery, you will probably be admitted to the hospital early in the morning. You will be instructed to not eat or drink anything after midnight the night before surgery. You should plan on being in the hospital for at least one or two nights following surgery.

An artificial shoulder replacement is not the only treatment available for osteoarthritis of the shoulder. Once the diagnosis is made, your doctor may suggest several treatments to ease your pain and delay the artificial shoulder replacement. Like any arthritic condition, osteoarthritis of the shoulder may respond to anti-inflammatory medications such as aspirin or ibuprofen. The pain may also respond to acetaminophen (Tylenol® Arthritis Extended Relief).

Orthopaedic surgeons are using some of the newer medications such as glucosamine and chondroitin sulfate more commonly today. These medications may be effective in helping reduce the pain in osteoarthritis of all joints.

Physical therapy may be suggested to regain as much of the motion in the joint and strength in the shoulder muscles as possible before undergoing a shoulder replacement. An injection of cortisone into the shoulder joint may give temporary relief. Cortisone is a powerful anti-inflammatory medication that can ease the inflammation and reduce the pain, possibly for several months. Most surgeons will limit the number of cortisone shots in any joint to two or three. If the shots fail to provide any lasting relief for several weeks to several months, your doctor may suggest surgery to replace the shoulder.

The symptoms of osteoarthritis of the shoulder are pain and reduced movement in the shoulder. The pain is typically aching in nature and can make it difficult to sleep. Certain movements may cause a grinding sensation or a catching sensation as the arthritic bone surfaces move against one another. Usually it is difficult to see any swelling in the shoulder joint because so much muscle covers it.