The most common problem leading to a shoulder replacement surgery is osteoarthritis, or “wear-and-tear” arthritis. Osteoarthritis can occur without any injury to the shoulder, but that is uncommon, because the shoulder is not a weight-bearing joint. Osteoarthritis caused by wear and tear is more common in the hip and knee. More commonly, osteoarthritis occurs many years after an injury to the shoulder. A shoulder dislocation can result in chronic instability of the shoulder joint. Repeated dislocations over many years damage the joint, leading to arthritis. Some fractures of the shoulder can also lead to arthritis.
Other types of arthritis affect the shoulder joint as well. Systemic diseases, such as rheumatoid arthritis, affect all the joints of the body. The result is much the same as osteoarthritis, making the shoulder painful and, therefore, difficult to use.
The symptoms of osteoarthritis of the shoulder are pain and reduced movement in the shoulder. The pain is typically aching in nature and can make it difficult to sleep. Certain movements may cause a grinding sensation or a catching sensation as the arthritic bone surfaces move against one another. Usually it is difficult to see any swelling in the shoulder joint because so much muscle covers it.
The diagnosis of osteoarthritis of the shoulder begins with a complete history of the problem, followed by a physical examination of the shoulder. Your doctor will ask you about old injuries of the shoulder. A physical examination will be performed to try and determine how much strength and motion you have in the shoulder. Your doctor may look at other joints for other signs of systemic arthritis. X-rays of the shoulder will be necessary to make the diagnosis of osteoarthritis. X-rays will show the degree of changes in the bones of the shoulder and give some idea as to how much wear and tear is present. With your surgeon’s guidance, you’ll decide whether to consider joint replacement.