SHOULDER ARTHRITIS

The shoulder is a common source of disability resulting from traumatic and degenerate tears of the rotator cuff, subacromial impingement, and osteoarthritis. Nonoperative management has focused treatment on pain-killers and analgesics and anti-inflammatory medications. Sometimes a steroid injection.

Stem cell therapy can be an alternative to shoulder replacement.

Doctors in Germany looked at the options to repairing cartilage defects and soft tissue injury in the shoulder before it lead to osteoarthritis. They concluded that stem cell therapy for cartilage regeneration was a minimally invasive approach for shoulder joint preservation and an alternative to shoulder replacement.1

SHOULDER OSTEOARTHRITIS TREATMENT – REPAIRS OF DEGENERATE AND TORN TISSUE

Surgical repairs of degenerate and torn tissue are often prone to failure… It is assumed that some biological therapies (Platelet Rich Plasma therapy or Stem Cell Therapy) might improve outcomes, in fact, injections of platelet-rich plasma (PRP) have led to reduced pain and improved recovery in other degenerated areas together with the restoration of function.2

Because the shoulder does not usually bear our body weights (unless we do an extraordinary amount of chin-ups or even push-ups) it is not subject to the type of damage that causes osteoarthritis (bone-on-bone type degeneration) that occurs in the hips and knees.

Arthritis to the shoulder is usually triggered by an injury such as a dislocation or separation that has not healed properly. In these cases or even in the cases of past surgical intervention, connection soft tissues–the ligaments, tendons, and cartilage, have not completely healed or have become overstretched (ligament and tendon laxity).

This causes an excessive amount of “play” in the joint resulting in the previously mentioned chronic shoulder instability. When bones rub against bones or against soft tissue, inflammation, swelling and pain occurs. Over time, painful bone spurs may form and a surgical consult called for.

Often people will react by instinctively limiting their shoulder movements in order to lessen the pain. This can lead to a tightening or stiffening of the soft tissue parts of the joint, resulting in yet further pain and restriction of motion. In the worst cases, adhesive capsulitis may occur.

 

DIAGNOSIS OF SHOULDER OSTEOARTHRITIS

A proper diagnosis of shoulder pain is essential to determine the root cause of the problem and the proper method of treatment because many shoulder conditions are caused by specific activities, such as over use caused by excessive workouts, a detailed medical history is an invaluable tool.

A physical examination should also include screening for physical abnormalities—swelling, deformity, muscle weakness, and tender areas—and observing the range of shoulder motion—how far and in which directions the arm can be moved.

Many of the structures inside of joints that are injured do not hurt when you press on the outer surfaces. These inner structures can also, often be healed.

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1. Banke IJ, Vogt S, Buchmann S, Imhoff AB. [Arthroscopic options for regenerative treatment of cartilage defects in the shoulder]. Orthopade. 2011 Jan;40(1):85-92. doi: 10.1007/s00132-010-1682-5.

2. Mei-Dan O, Carmont MR. The role of platelet-rich plasma in rotator cuff repair. Sports Med Arthrosc. 2011 Sep;19(3):244-50.