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Treatment of Younger, Active Patients with Shoulder Arthritis
The shoulder is comprised of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). The shoulder (the glenohumeral joint) is a ball-and-socket joint, with the ball (humeral head) of the arm bone fitting into the socket (glenoid) of the shoulder blade. Articular cartilage covers the joint surfaces, and a lubricant (synovial fluid) eliminates friction and allows the ball to move smoothly in the socket. This joint, along with the rotator cuff muscles and tendons, allow a healthy shoulder joint to have a greater range of motion than any other joint in the body.
Arthritis causes loss of cartilage surface of the glenohumeral joint, resulting in loss of range of motion and pain, affecting one’s ability to perform daily activities, work, and engage in recreation and sports. The pain often interferes with sleep. Surgical treatment is an option when rest, medications, injections, and physical therapy do not help.
There are now surgical options to provide pain relief and improved range of motion while allowing for an active and vigorous lifestyle.
Younger patients who have arthritis of the shoulder may have different treatment requirements than older patients due to typically higher levels of activity and greater longevity needs for shoulder replacement. Traditional total shoulder replacement surgery is the gold standard surgical treatment and can provide pain relief and return to function. However, if a person has an active lifestyle, the life of the replacement implants may be shortened due to wear and tear and loosening.
There are now surgical options available for some patients who intend to resume an active lifestyle: humeral resurfacing and humeral head replacement with glenoid reaming arthroplasty (ream and run). These procedures only replace the humeral head without replacing the glenoid, and provide pain relief and improved range of motion while allowing for an active and vigorous lifestyle without risk of glenoid (socket) loosening.
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