Shoulder osteoarthritis : diagnosis, causes and treatment

Omarthritis or the degenerative wear of the cartilage on the head of the humerus

The head of the humerus (the top of the bone) articulates with the glenoid cavity, a groove in the scapula. The surfaces of these bones are covered with cartilage and shoulder osteoarthritis is the wear of this cartilage. Debris can build up and bone remodelling can occur causing aggravated pain and loss in mobility as well as blocking of the joint.

Les traitements médicaux de l’arthrose de l’épaule

Le traitement en tant que tel sera similaire qu’il s’agisse d’une omarthrose centrée ou excentrée. Dans un premier temps antalgiques et anti-inflammatoires non-stéroïdiens sont prescrits pour soulager la douleur et sont associés à une rééducation. Lorsque ces traitements ne parviennent plus à soulager le patient, des infiltrations d’Altim, un anti-inflammatoire stéroïdien de la famille des corticoïdes de synthèse, une viscosupplémentation à l’acide hyaluronique ou une injection de concentré plaquettaire (PRP) peuvent être envisagées. Une injection de cellules souches peut également être discutée.

Primary or secondary omarthritis?

The disease can occur following a trauma, in particular after rupture of the rotator cuffs. In this case, we talk of secondary omarthritis: the head of the humerus is no longer correctly aligned in the glenoid.
In the case of primary shoulder osteoarthritis linked to the wear and tear of the joint, the shoulder tendons remain intact and the head of the humerus remains correctly positioned in the glenoid. Primary omarthritis requires a rigorous medical follow-up to ensure the good condition of the tendons to avoid the possible rupture of the rotator cuffs.

Medical treatment of shoulder osteoarthritis

The treatment itself is similar for primary and secondary omarthritis. Initially, analgesics and non-steroidal anti-inflammatories can be prescribed to relieve the pain in association with rehabilitation. When the treatments no longer provide any relief for the patient, Altim injections, a synthetic corticosteroidal anti-inflammatory, hyaluronic acid viscosupplementation or platelet rich plasma therapy (PRP) can be envisaged. Stem cell injections can also be discussed.

Total shoulder replacement: not too soon, not too late

Surgery can sometimes prove necessary to treat shoulder osteoarthritis: conservative surgery (performed arthroscopically) to help clean any debris, or total shoulder replacement. The latter, very reliable these days, consists in removing the worn bone and cartilage and replacing them with synthetic parts. The pain disappears and the mobility of the shoulder joint is restored.