Shoulder osteoarthritis

The shoulder is a remarkable joint that allows us to perform a multitude of movements in our daily lives. When the rotator cuff is damaged, this entire freedom of movement is compromised. This condition, which affects the stabilizing tendons of the shoulder, affects many people and often manifests as pain that disrupts sleep and limits activity.

Causes

Shoulder osteoarthritis results from multiple factors that gradually lead to the deterioration of joint cartilage. Repeated microtrauma during professional or sporting activities that place intensive demands on the shoulder are a common cause. Poorly healed joint fractures and chronic rotator cuff injuries also accelerate the degenerative process. Certain diseases such as rheumatoid arthritis or chondrocalcinosis predispose to this condition. Heredity plays a significant role, with some families showing increased susceptibility. Chronic shoulder instabilities, whether traumatic or constitutional, also promote the early onset of osteoarthritis.

Symptoms

Pain is the main symptom of shoulder osteoarthritis. It initially manifests during movement and gradually intensifies to become present even at rest. Nighttime awakenings are frequent, significantly disrupting sleep quality. Joint stiffness gradually sets in, limiting range of motion and making everyday activities such as dressing or combing hair difficult. When the rotator cuff is affected, muscle weakness is added to the clinical picture, further complicating activities requiring arm lifting. The natural course of the disease leads to a progressive worsening of symptoms with increasing functional deterioration of the shoulder.

Treatments

Therapeutic management is tailored to the severity of osteoarthritis and its functional impact. In early stages, joint rest combined with anti-inflammatory drugs can provide significant relief. Corticosteroid injections, administered under ultrasound guidance, often reduce inflammation and pain for several months. Physiotherapy plays a central role in conservative treatment. It aims to soften the capsular structures, relax, and then strengthen the periarticular muscles to optimize shoulder function. Analgesic techniques such as cryotherapy or electrotherapy usefully complement this approach. However, when osteoarthritis becomes severe and conservative treatments are no longer sufficient to control symptoms, surgery becomes the most appropriate therapeutic solution.

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Surgery

The surgical procedure aims to replace worn joint surfaces with prosthetic implants. The choice of prosthesis type depends on several parameters: the integrity of the rotator cuff, the available bone stock, and the patient's functional requirements. A total anatomical prosthesis is preferred when the rotator cuff is intact. In the case of a massive and irreparable tear of the cuff, a reverse prosthesis compensates for tendon insufficiency by modifying the biomechanics of the shoulder. The procedure, performed under general anesthesia combined with an analgesic nerve block, lasts approximately one and a half hours. The arm is immobilized in an orthopedic vest for four to six weeks. Rehabilitation, begun early according to an established protocol, determines the quality of the functional result. Hospitalization lasts approximately one week, with the possibility of arranging home help to facilitate the return.

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This article is original and was created entirely by our team of referring physicians. Last updated September 17, 2025.

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Specialist in orthopedic surgery and traumatology. Shoulder surgery

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