Shoulder Arthritis Treatment Options

Shoulder arthritis is a chronic condition that can result in significant pain and disability. Studies report that it can affect up to one-third of people over the age of 60. The goal of treatment is to help you live with arthritis pain and to decrease the negative impact of the disease on your well-being. The treatment options for shoulder arthritis will depend on the severity of your condition.

Conservative treatment

First-line treatment is conservative, nonoperative management recommended to manage pain and improve joint function. This includes:

• rest
• activity modifications to manage pain and improve joint function
• over the counter oral NSAIDs and prescription pain medications to reduce pain and inflammation, and topical creams like an NSAID anti-inflammatory Arthritis Pain Gel
• physical therapy to improve strength, function and range of motion
• low impact exercise to improve strength and flexibility
• weight loss if needed
• adopting an anti-inflammatory diet
• cold and heat therapy
• massage
• acupuncture to relieve pain

Second-line treatment includes steroid injections to reduce inflammation, possibly hyaluronic acid injections to improve joint lubrication, and biologics like platelet rich plasma and stem cell injections may be recommended to reduce your symptoms. When nonsurgical treatments do not provide pain relief and improved function, joint replacement surgery may be considered.

Surgical Treatment Options

Arthroscopic debridement

This procedure involves making small incisions and inserting a camera called an arthroscope to view the joint. Live images are displayed on a video monitor. Dr. Petrigliano uses these images to insert and guide small surgical instruments to clean out the joint, remove any loose tissue or bone, and smooth out rough surfaces in the joint. The goal is pain relief and improved function.

Shoulder Joint Replacement (Arthroplasty)

When arthritis restricts function and makes daily life difficult and painful, and medications and physical therapy fail to improve your pain, shoulder replacement is the best option. Shoulder replacement is indicated for patients with end-stage osteoarthritis that has destroyed the cartilage at the ends of the shoulder bones causing severe pain that negatively impacts quality of life, and which has failed to improve with nonsurgical treatments. Other indications include moderate to severe joint pain while resting, pain interferes with sleep, loss of motion and/or shoulder weakness.  The goal is pain relief and restored range of motion and function.

Total shoulder arthroplasty

Total shoulder replacement is the gold standard treatment for patients with a severely damaged joint due to shoulder arthritis who have an intact rotator cuff. It may be performed as a minimally invasive surgical procedure or an open procedure to relieve pain and restore movement in the shoulder. During replacement the damaged joint surfaces, the head of the upper arm bone and the socket, are removed and replaced with implants make of high-impact plastic and metal that are designed to fit together to restore shoulder anatomy and function. The average age for a total shoulder replacement is a patient between the ages of 60-80.

Total shoulder replacement provides excellent pain relief and reliably restores function in patients with glenohumeral arthritis. 95% of patients have pain-free function one year after surgery. Most are able to return to the sports and activities that make life enjoyable.

It is also available for younger patients with specific types of glenohumeral arthritis like post-traumatic arthritis.  A 2016 study reported that 96.4 percent of recreational athletes aged 55 and younger who underwent total shoulder replacement returned to at least one sport, on average within seven months of surgery.

Candidates for total shoulder must have a healthy and well-functioning rotator cuff to achieve the best results. If the rotator cuff is irreparably damaged, Dr. Petrigliano will recommend a reverse shoulder replacement.

Reverse Total Shoulder Replacement

This procedure also replaces the ball and socket joint with implants, but the positions of the ball and socket are reversed. Importantly, function doesn’t rely on the rotator cuff. Instead it relies on the deltoid muscles.  Reverse shoulder is a reliable option that provides significant improvements in pain, range of motion and strength. It has typically been reserved for patients only than 65 but studies report that it is also a good option for younger patients.

Resurfacing hemiarthroplasty and stemmed hemiarthroplasty

Resurfacing hemiarthroplasty and stemmed hemiarthroplasty may be preferred to total shoulder replacement in some individuals who are not ideal patients for total shoulder arthroplasty, especially young and active patients, who have high physical demands, and for other reasons. It only replaces the head of the upper arm bone. It also provides pain relief.

Dr. Frank Petrigliano is an orthopaedic surgeon who was fellowship trained in sports medicine and shoulder surgery at the prestigious Hospital for Special Surgery where he provided care to athletes of all ages. He currently serves as the head team physician for the LA Chargers football team and associate team physician for UCLA Athletics. Dr. Petrigliano is a renowned orthopaedic surgeon and researcher who employs state of the art treatments and procedures to get you back to your active life and back to sport. He always treats his patients with compassion and respect. Dr. Petrigliano is located in Santa Monica California, and serves greater Los Angele and the South Bay. Contact Dr. Petrigliano to schedule a consultation today.