Articular surface of the bone that forms the shoulder joint (humeral extremity and glenoid cavity of the scapula) is covered with a thin layer of cartilage.
This is acartilage with very smooth surface, moisturised all the time by the synovial fluid, providing good slipping of the joint surfaces in contact during shoulder movement. With age, or as a result of various events (accident, surgery, infection), cartilage surface diminishes revealing the bone underneath. During movement, fragments of uncovered bone come into contact with opposing articular surfaces and lead to the appearance of inflammatory pain.
Pain is diffuse, sometimes radiates to the arm and elbow, is stronger at night and wakes up patients. At first, is disappears after taking anti-inflammatory drugs, but with time, its response diminishes.
Patients no longer get to sleep on that shoulder, arm movementis difficult and amplitudes decrease progressively (especially abduction – motion that moves the arm away from the body).
Everyday gestures become difficult (bra closure, getting dressed, hairwashing).
Several tests are required, but even on a first X-ray we can find the stigmas of these degenerative injuries of arthrosis.
Summary can be completed with further tests, such as ultrasound, MRI and arthrogram.
Anti-inflammatory drugs and painkiller may temporary remove symptoms and relieve pain.
Kinesiotherapy sessions allow recovery of joint amplitudes, pain alleviation and especially muscle contraction.
Infiltrations: use of local products containing cortisone. They can alleviate pain for weeks or even months. Joint amplitudes are partially recovered; even if these products do not provide injury healing, they allow for adjournment of surgery for a while.
Hyaluronic acid: A product that has the same formula as the liquid that is normally found in all joints of the human body. This injected product improves cartilage vitality and allows better sliding of joint surfaces in motion; patients regain joint flexibility and obtain pain relief.
Glucosamine and chondroitin sulphate:they rarely play a role in improving shoulder function and joint flexibility, even if these products are precursors of cartilage
Growth factors can help reduce inflammation. The higher their concentration (depending on the procedure performed), the longer their anti-inflammatory action lasts.
Mesotherapy andacupuncture give random results
This means in most cases the implantation of prosthesis. The type of prosthesis used is based on the existing injuries.
We will use a partial humeral prosthesis for injuries that focus on the humeral head.
Another option is humeral prosthesis with the entire humeral head replacement. Total prosthesis replaces the entire joint and is indicated when arthrosis is global.
In patients with major tears of the rotator cuff, we use special prostheses, called reversed prostheses.