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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2011 April;62(2):109-20
The management of osteoarthritis of the shoulder
Kircher J., Krauspe R.
Department of Orthopedics, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
Osteoarthritis of the shoulder is a common problem in orthopedic practice usually affecting people in the seventh decade of life. The underlying pathomechanism of primary osteoarthritis of the shoulder remains unclear whereas more and more predisposing factors and conditions leading to secondary omarthrosis are identified. Pain during all-day activities and at night together with a limited range of motion are the clinical features. The diagnosis is based on a thorough clinical examination in conjunction with a set of standard radiographs. The radiological appearance shows a typical pattern of reduction of joint space, formation of caudal osteophytes and deformation of the humeral head. Advanced stages of the disease usually are complicated by glenoid erosion, dorsal decentering of the humeral head and bone stock erosion. The aim of the surgical therapy is restoration of shoulder function and pain relief by hemi- or total shoulder arthroplasty. The results are generally very good with a low complication rate. Implant survival and revision rates using modern implant designs and techniques are comparable to that of hip and knee replacement. Further improvement of functional results and long-term survival can be expected by improved implant designs, fixation techniques and the use of intraoperative navigation.