Shoulder arthritis

Shoulder arthritis presents with pain and loss of function. It commonly affects the elderly but can present in young and active patients.

There are many causes for developing shoulder arthritis. The commonest of these is osteoarthritis. Other causes include rheumatoid/inflammatory arthritis, post traumatic arthritis, secondary to avascular necrosis (loss of blood supply to the head), secondary to infection and rotator cuff tears.

It is important to understand the aetiology as this would affect the treatment plan.

The indications for the treatment of shoulder arthritis are pain with loss of function and proven arthritis on X-rays, together with failure of conservative management (analgesia, physiotherapy and activity modification). The choice of treatment is dependent on the patient age, type of arthritis, the integrity of the rotator cuff tendon and the bony architecture.

Arthroscopic debridement (keyhole surgery) is usually preserved for the younger patients with early arthritis. Total shoulder replacement is the treatment of choice for osteoarthritis. Reverse geometry total shoulder replacement has specific indications including cuff tear arthropathy and certain fractures.