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Glenohumeral Arthritis
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Introduction to Glenohumeral Arthritis
Glenohumeral arthritis is a degenerative joint disease affecting the shoulder’s glenohumeral joint, where the humerus (upper arm bone) meets the scapula (shoulder blade). Characterized by the wearing away of cartilage, it leads to pain, stiffness, and reduced mobility.
As the disease progresses, patients may experience significant discomfort and disability, impacting their quality of life. Early and accurate diagnosis is key to effective management and slowing the condition’s progression.
Causes of Glenohumeral Arthritis
Glenohumeral arthritis stems from several factors that contribute to the deterioration of the joint’s cartilage. Primary causes include:
- Age-related Degeneration: The most common cause, where cartilage wears away over time due to ageing.
- Post-traumatic Arthritis: Arising after shoulder injuries such as fractures or dislocations, which can damage the cartilage.
- Rheumatoid Arthritis: An autoimmune condition that causes inflammation and can lead to joint damage, including in the shoulder.
- Osteonecrosis: A condition where blood flow to the bone ends is disrupted, leading to bone death and secondary arthritis.
- Rotator Cuff Tear Arthropathy: A specific type of arthritis that develops after large, long-standing rotator cuff tears, affecting the joint’s mechanics and leading to cartilage loss.
Symptoms of Glenohumeral Arthritis
Common symptoms of Glenohumeral Arthritis include:
- Pain
Initially, discomfort may occur only during activity, but as the condition advances, pain might persist even at rest. - Stiffness
A noticeable reduction in the range of motion of the shoulder, making daily activities challenging. - Crepitus
A grinding or catching sensation when moving the shoulder, due to irregularities in the cartilage or the presence of loose bodies within the joint. - Weakness
Joint instability or eroded muscular function around the shoulder can lead to a lack of arm strength. - Swelling
Following exercise or major effort, mild to moderate enlargement of the glenohumeral joint may be noticeable, typically from the increase in synovial fluid as an inflammation response.
Diagnosis
Diagnosis of Glenohumeral Arthritis includes a comprehensive approach for accurate guidance, it typically involves:
Patient History and Clinical Examination
The discussion includes the start of the symptoms, any history of trauma, family history of arthritis, and how the condition impacts daily life. Examinations may also be done, this entails a comprehensive examination of the shoulder, assessing the range of motion, pain points, mobility or age, or other adversities.
Imaging Studies
- X-rays provide clear visuals of bone spurs and joint space narrowing, direct arthritis indicators.
- MRI Scans reveal the extent of cartilage loss, the state of the rotator cuff tendons, and any ligament or soft tissue swelling.
- CT Scans may be employed to assess the amount of bone loss and severity of deformity in the shoulder.
Non-Surgical Treatments
Treating glenohumeral arthritis non-surgically aims to alleviate pain, reduce inflammation, and improve joint function, ideally delaying or avoiding the need for surgery. Common leading non-surgical interventions include:
Physical Therapy
Tailored exercises to strengthen the rotator cuff and shoulder-stabilizing muscles, enhancing joint support, and mobility.
Medications
NSAIDs (non-steroidal anti-inflammatory drugs) to manage pain and reduce inflammation. For some patients, acetaminophen may be recommended as an alternative.
Corticosteroid Injections
Administered directly into the shoulder joint, these can provide significant pain relief and reduce inflammation for short to medium terms.
Hyaluronic Acid Injections
Sometimes used to supplement the natural ‘lubricating’ fluid in the shoulder joint, potentially improving mobility and reducing discomfort.
Activity Modification
Adjusting lifestyle and activities to avoid aggravating the arthritis, including teaching lifting and weight-bearing limitations.
Surgical Interventions
For cases of glenohumeral arthritis where non-surgical treatments fail to provide adequate relief, surgical options may be considered. These interventions include:
- Arthroscopy
In early stages or less severe cases, arthroscopic surgery can be used to clean out the joint, removing loose cartilage, inflamed synovial tissue, and bone spurs. This minimally invasive procedure may offer pain relief and improved function with a shorter recovery time. - Shoulder Joint Replacement (Arthroplasty)
For advanced arthritis, total shoulder arthroplasty replaces the damaged joint surfaces with artificial components. An alternative, hemiarthroplasty, replaces only the head of the humerus. These procedures can significantly reduce pain and improve joint mobility. - Reverse Shoulder Arthroplasty
Recommended for patients with combined glenohumeral arthritis and significant rotator cuff damage, this surgery reverses the ball-and-socket orientation of the shoulder to improve stability and function. - Osteotomy
Although less common, osteotomy involves reshaping the bones to improve joint alignment and reduce arthritis symptoms. This option might be considered in specific cases.
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
Prevention Methods
While it may not be possible to prevent glenohumeral arthritis entirely, certain measures can reduce the risk or slow the progression of the disease:
- Maintain a Healthy Weight: Excess weight can increase stress on the joints, including the shoulders.
- Regular Exercise: Strengthening the muscles around the shoulder joint can help support and protect the joint.
- Avoid Overuse: Limit repetitive activities that put excessive stress on the shoulder.
- Proper Technique: Use proper form and techniques when engaging in sports or physical activities to avoid injury.
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Frequently Asked Questions (FAQs)
Can glenohumeral arthritis affect both shoulders?
Yes, glenohumeral arthritis can affect both shoulders, although it might start in just one. It’s particularly common for systemic conditions like rheumatoid arthritis to involve both sides. Over time, wear and tear or the progression of an underlying disease can lead to symptoms developing in the other shoulder as well.
Is glenohumeral arthritis reversible?
Unfortunately, glenohumeral arthritis is not reversible, as the damage to the cartilage in the joint cannot be naturally repaired by the body. However, treatment strategies can significantly reduce symptoms and slow the progression of the disease.
Can diet affect glenohumeral arthritis?
Diet can play a supportive role in managing glenohumeral arthritis. Anti-inflammatory foods, such as fruits, vegetables, nuts, and fish rich in omega-3 fatty acids, may help reduce joint inflammation and pain.
How long does it take to recover from shoulder arthroplasty?
Recovery time from shoulder arthroplasty varies depending on the individual’s health, the type of surgery performed, and their commitment to post-surgical rehabilitation. Initially, movement is limited to promote healing, with a gradual introduction of physical therapy to restore range of motion and strength. Full recovery, where patients can return to their normal daily activities, often takes several months, but significant improvements can be noticed within the first few weeks post-operation.