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Dr Priyadarshi Amit, senior consultant, Shoulder, Elbow & Upper limb Surgeon answers few of the commonly asked questions about Shoulder Arthritis.

What is arthritis?

Arthritis refers to destruction of the joint with loss of a specialized structure known as cartilage in the joint. It usually causes joint pain of varying severity, swelling, difficulty in movement, and limits function of that joint. It can affect the individual to a various degree in his overall mental and physical health as well as personal and social life.

Why does one get arthritis?

Arthritis can occur due to various reasons. The most common is advancing age, what we call as osteoarthritis, or inflammatory diseases most common being rheumatoid arthritis. Infact, every person is prone to get age-related arthritis in one or the other joint. In shoulder joint, arthritis is more commonly seen due to damage to the muscle around the shoulder joint, known as rotator cuff tears due to advancing age or injury, known as rotator cuff arthropathy.

One of my parents has arthritis, am I likely to get it?

Now, it depends on the type of arthritis. Yes, it can run in family in cases of inflammatory arthritis. If it’s another variety of arthritis, you should not be worried.

Can it be prevented or cured?

I think it’s difficult to prevent age-related arthritis from happening to a joint. It’s a progressive condition. But, of course, there are few measures you can take to reduce its symptoms or delay its progression. With regards to inflammatory arthritis, there are various medications which can easily control your symptoms.

Can I lead my normal life with arthritis?

The severity of symptoms vary from patient to patient. Sometimes, patients have surprisingly minimal symptoms despite severe arthritis. On the other hand, other patients have severe disabling symptoms. However, patients can get back to normal life after appropriate treatment.

Do I have to have surgery?

Not necessarily, if your symptoms are mild or well controlled with non-operative measures you need not go for surgery. Essentially, we have range of treatment options for varying degree of arthritis. In early stages, simple measures such as lifestyle modification, weight loss, painkillers, physical therapy can reduce your pain. The intra-articular injections can control symptoms for a longer term. When these measures fail, we start looking at some sort of surgical solutions where the definitive solution is a joint replacement surgery where the damaged part of the ball and socket joint is replaced with artificial implants.

I don’t want replacement surgery, is there any other surgical treatment option?

Yes, we do consider joint preservation surgery such as CAM surgery (Comprehensive arthroscopic management) or biological resurfacing where we retain your native joints. These are minimally invasive procedures and offers quicker rehabilitation and early return to normal activities. Unfortunately, there are restricted indication where one can perform these procedures.

When should I go for replacement surgery?

You shoulder consider replacement surgery if you are struggling with symptoms which is affecting your life despite taking all non-surgical measures. Broadly there are two designs of implants in shoulder replacement; anatomical where the ball and socket orientation of the joint is maintained, and the other one is reverse shoulder replacement where the orientation is reversed to obtain the mechanical advantage of this geometry.

Is replacement surgery successful?

Yes, with modern technology and advanced techniques, joint replacement surgery is very successful in bringing you back into routine life. Although there are few complications which can occur, fortunately these happen in very small percentage of patients.

How long does one replacement implant last?

With the current implant options, we can provide the patients with joints that can last 15-20 years, for some it may be their lifetime.

Can arthritis involve elbow and wrist joint? And can this also be treated?

Yes, in elbow joint I see arthritis more commonly after injury, than osteoarthritis or rheumatoid arthritis, thanks to very effective anti-rheumatoid medication. About the wrist and small joints of the hand, again, the arthritis is not very uncommon. However, we do have surgical solutions for these joints also. The total elbow replacement is again very successful in improving symptoms, however has slightly less longevity than shoulder replacements. In wrist joints, one has to choose from various wrist fusion surgeries or wrist replacement.

In a nutshell, in today’s era, arthritis is not a disease to be worried about. We have got treatment options that can put the patients with arthritis back into action.

Dr Priyadarshi Amit

Senior Consultant Shoulder, Elbow & Upper limb Surgeon