Glenohumeral Arthritis
Glenohumeral arthritis is a degenerative joint disease affecting the shoulder. It is characterized by degeneration or wearing away of the protective cartilage (articular cartilage) covering the ends of the bones in the joint. As the articular cartilage degenerates, the bone ends rub against each other causing inflammation and pain. The main joint in the shoulder is a ‘ball-and-socket’ joint. The ‘ball’ at the top of the upper arm bone, humerus, fits neatly into a ‘socket’, the glenoid, which is part of the shoulder blade. Hence It is also called the glenohumeral joint. Glenohumeral arthritis is most often seen in people over 50 years. It can also develop after an injury or trauma to the shoulder. The condition may also be hereditary. A person with glenohumeral arthritis is likely to have tenderness and shoulder pain that is aggravated during activity. Swelling of the joint may also be seen. You may hear a clicking or creaking sound as you move your shoulder. To diagnose glenohumeral arthritis, your doctor will review your medical history and perform a physical examination of your shoulder. X-rays of an arthritic shoulder may be useful to see osteophytes (bone spurs) and loss of joint space. Treatment for glenohumeral arthritis includes both non-surgical treatment and surgical treatment. Non-surgical is similar to how knee OA is treated and includes use of anti-inflammatory medications, applying ice, moist heat to the joint, performing range-of-motion exercises and physical therapy, corticosteroid injections, and dietary supplements of glucosamine and chondroitin sulfate. Surgery may be indicated if non-surgical treatments are ineffective. This may involve arthroscopic debridement of the joint, releasing the capsule and manual manipulation to increase range of motion and decrease pain. In advanced stages, joint replacement may be indicated.
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Acromioclavicular Arthritis
The acromioclavicular joint is part of the shoulder joint. It is formed by the union of the acromion, a bony process of the shoulder blade, and the outer end of the collarbone or clavicle. The joint is lined by cartilage that gradually wears with age as well as with repeated overhead or shoulder-level activities. This can lead to shoulder pain which worsens with movement of the arm. Pain may radiate to the chest and neck. Movement of the shoulder may produce a clicking or snapping sound and bumps are occasionally felt over the joint. AC joint arthritis is commonly associated with rotator cuff tears and impingement. When you present with the above symptoms, your doctor will review your medical history and perform a physical examination. Pain and tenderness over the AC joint is elicited by palpation and movement of the arm to compress the joint. An anesthetic injection into the joint can temporarily reduce pain thus identifying the AC joint as the source of pain. X-rays may show loss of joint space, increased bone density or bony overgrowths (spurs). MRI scans may reveal cartilage damage and abnormal fluid accumulation within the joint. Your doctor may treat your symptoms non-operatively though activity modification. Pain can also be controlled by pain killers, anti-inflammatory medication and corticosteroid injections into the joint. If symptoms persist, surgery may be recommended. This usually involves a minimally invasive arthroscopic procedure to shave down the clavicle to prevent the bones in the joint from rubbing against each other. Bone spurs are removed and any adjacent injuries to tendons or ligaments are also addressed.
Distal Clavicle Resection
Subacromial Decompression
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Post operative care
Rehab protocol
Rheumatoid
Rheumatoid arthritis is an auto-immune disease in which the body’s immune system attacks healthy joints, tissues and organs. It can cause pain, stiffness, swelling, deformity and loss of function in joints. Fortunately, medical management is the mainstay of treatment as provided by rheumatologists. Occasionally, the same procedures offered for patients suffering from the symptoms of osteoarthritis are offered to patients with rheumatoid arthritis.