• Arthritis of the shoulder

    Glenohumeral Joint arthritis is a common condition. Historically treatment has been limited and therefore perhaps neglected until the advent of modern joint replacement for the shoulder  in the 1970’s with Dr Charles Neer in the USA. In fact a shoulder replacement was probably the first ever joint replacement done, in France by Pean in around 1893.

    What makes the shoulder unique is the variety of types of arthritis that affect it, and the fact that each type may require a different type of arthroplasty. Primary osteoarthritis for example usually has intact bone stock and a functioning rotatorpasscerty
    cuff and is therefore ideal for an anatomic, unconstrained prosthesis. Cuff tear arthritis however needs a different approach to compensate for loss of the rotator cuff in terms of increased stability and conferring mechanical advantage to the Deltiod so Reverse Geometry prostheses are used in this situation. Rheumatoid arthritis can behave a bit like both of the above, and avascular necrosis is quite a common cause of arthritis at the shoulder, both idiopathic and post trauma. Finally Instability arthritis is a secondary osteoarthritis, and as shoulder instability is a common condition, is also a common cause of arthritis, especially in young patients.

    Our current situation is that we have a great variety of 3rd and 4th generation implants, anatomic, bone sparing and reconstructive which have proven good results over the last 10-20 years. These results seem topasscerty.com be as good as Hip and Knee replacement. An exciting move in the UK is the inclusion of Shoulder and Elbow replacement on the National Joint Registry from April 2012. This data includes clinical scores for the first time and will be invaluable in monitoring individual implants, patient outcomes, and soon surgeon outcomes as well.

     

    Mr.Philip Ahrens (FRCS (Tr & Orth) Orthopedic Shouler and Elbow Surgeon)
    Royal Free London NHS Foundation Trust.
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