Osteoarthritis (OA) is the most frequent cause of disability in the USA, affecting up to 32.8% of patients over the age of sixty. Treatment of shoulder OA is often controversial and includes both nonoperative and surgical modalities. Nonoperative modalities should be utilized before operative treatment is considered, particularly for patients with mild-to-moderate OA or when pain and functional limitations are modest despite more advanced radiographic changes. If conservative options fail, surgical treatment should be considered. Although different surgical procedures are available, as in other joints affected by severe OA, the most effective treatment is joint arthroplasty. The aim of this work is to give an overview of the currently available treatments of shoulder OA. 1. Background Osteoarthritis (OA) is the most frequent cause of disability in the USA [1]. Although not as prevalent as OA of the hip or knee, OA of the shoulder has been demonstrated, in cadaver and radiographic studies, to affect up to 32.8% of patients over the age of sixty years [2, 3] and to be equally debilitating [4]. Patients perceive that the impact of shoulder OA is comparable with that of chronic medical conditions such as congestive heart failure, diabetes, and acute myocardial infarction [5]. The prevalence of shoulder OA increases with age and women appear to be more susceptible than men [6]. OA of the shoulder is the consequence of destruction of the articular surface of the humeral head and glenoid and results in pain and loss of function. It can be primary or secondary. Primary OA is diagnosed when no predisposing factors that could lead to joint malfunction are present. Secondary OA may occur as a result of chronic dislocations and recurrent instability, trauma, surgery, avascular necrosis, inflammatory arthropathy, and massive rotator cuff tears [7, 8] (Figure 1). Figure 1: Shoulder OA: radiographic appearance with (a) and without (b) an intact rotator cuff. Treatment of shoulder OA is often controversial and is typically based on the patient’s age, severity of symptoms, level of activity, radiographic findings, and medical comorbidities [9]. Nonoperative treatment options include activity modification, physical therapy, anti-inflammatory drugs (NSAIDs), and intra-articular injections. If conservative options fail, surgical treatment should be considered. Although different surgical procedures are available, as in other joints affected by severe OA, the most effective treatment is joint arthroplasty [10]. The aim of this work is to give an overview of the currently
References
[1]
Centers for Disease Control and Prevention (CDC), “Prevalence and most common causes of disability among adults—United States, 2005,” Morbidity and Mortality Weekly Report (MMWR), vol. 58, no. 16, pp. 421–426, 2009.
[2]
R. Kerr, D. Resnick, C. Pineda, and P. Haghighi, “Osteoarthritis of the glenohumeral joint: a radiologic-pathologic study,” American Journal of Roentgenology, vol. 144, no. 5, pp. 967–972, 1985.
[3]
C. J. Petersson, “Degeneration of the gleno-humeral joint. An anatomical study,” Acta Orthopaedica Scandinavica, vol. 54, no. 2, pp. 277–283, 1983.
[4]
I. K. Y. Lo, R. B. Litchfield, S. Griffin, K. Faber, S. D. Patterson, and A. Kirkley, “Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis: a prospective, randomized trial,” The Journal of Bone & Joint Surgery A, vol. 87, no. 10, pp. 2178–2185, 2005.
[5]
G. M. Gartsman, M. R. Brinker, M. Khan, and M. Karahan, “Self-assessment of general health status in patients with five common shoulder conditions,” Journal of Shoulder and Elbow Surgery, vol. 7, no. 3, pp. 228–237, 1998.
[6]
J. Cushnaghan and P. A. Dieppe, “Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites,” Annals of the Rheumatic Diseases, vol. 50, no. 1, pp. 8–13, 1991.
[7]
B. J. Cole, A. Yanke, and M. T. Provencher, “Nonarthroplasty alternatives for the treatment of glenohumeral arthritis,” Journal of Shoulder and Elbow Surgery, vol. 16, no. 5, supplement, pp. S231–S240, 2007.
[8]
K. J. Boselli, C. S. Ahmad, and W. N. Levine, “Treatment of glenohumeral arthrosis,” American Journal of Sports Medicine, vol. 38, no. 12, pp. 2558–2572, 2010.
[9]
O. A. van der Meijden, T. R. Gaskill, and P. J. Millett, “Glenohumeral joint preservation: a review of management options for young, active patients with osteoarthritis,” Advanced Orthopaedics, vol. 2012, Article ID 160923, 9 pages, 2012.
[10]
F. A. Matsen III, C. A. Rockwood Jr., M. A. Wirth, and S. B. Lippitt, “Glenohumeral arthritis and its management,” in The Shoulder, C. A. Rockwood Jr. and F. A. Matsen III, Eds., pp. 879–888, Elsevier Saunders, Philadelphia, Pa, USA, 2nd edition, 1998.
[11]
P. J. Denard, M. A. Wirth, and R. M. Orfaly, “Management of glenohumeral arthritis in the young adult,” The Journal of Bone & Joint Surgery A, vol. 93, no. 9, pp. 885–892, 2011.
[12]
L. P. McCarty III and B. J. Cole, “Nonarthroplasty treatment of glenohumeral cartilage lesions,” Arthroscopy, vol. 21, no. 9, pp. 1131–1142, 2005.
[13]
R. Izquierdo, I. Voloshin, S. Edwards et al., “Treatment of glenohumeral osteoarthritis,” Journal of the American Academy of Orthopaedic Surgeons, vol. 18, no. 6, pp. 375–382, 2010.
[14]
E. Silverstein, R. Leger, and K. P. Shea, “The use of intra-articular hylan G-F 20 in the treatment of symptomatic osteoarthritis of the shoulder: a preliminary study,” American Journal of Sports Medicine, vol. 35, no. 6, pp. 979–985, 2007.
[15]
W. Zhang, A. Jones, and M. Doherty, “Does paracetamol (acetaminophen) reduce the pain of osteoarthritis?: a meta-analysis of randomised controlled trials,” Annals of the Rheumatic Diseases, vol. 63, no. 8, pp. 901–907, 2004.
[16]
T. Pincus, G. Koch, H. Lei et al., “Patient Preference for Placebo, Acetaminophen (paracetamol) or Celecoxib Efficacy Studies (PACES): two randomised, double blind, placedo controlled, crossover clinical trials in patients with knee or hip osteoarthritis,” Annals of the Rheumatic Diseases, vol. 63, no. 8, pp. 931–939, 2004.
[17]
M. J. Kelley and M. L. Ramsey, “Osteoarthritis and traumatic arthritis of the shoulder,” Journal of Hand Therapy, vol. 13, no. 2, pp. 148–162, 2000.
[18]
J. Y. Bishop and E. L. Flatow, “Management of glenohumeral arthritis: a role for arthroscopy?” Orthopedic Clinics of North America, vol. 34, no. 4, pp. 559–566, 2003.
[19]
B. D. Cameron and J. P. Iannotti, “Alternatives to total shoulder arthroplasty in the young patient,” Techniques in Shoulder and Elbow Surgery, vol. 5, no. 3, pp. 135–145, 2004.
[20]
B. D. Cameron, L. M. Galatz, M. L. Ramsey, G. R. Williams, and J. P. Iannotti, “Non-prosthetic management of grade IV osteochondral lesions of the glenohumeral joint,” Journal of Shoulder and Elbow Surgery, vol. 11, no. 1, pp. 25–32, 2002.
[21]
D. P. Richards and S. S. Burkhart, “Arthroscopic debridement and capsular release for glenohumeral osteoarthritis,” Arthroscopy, vol. 23, no. 9, pp. 1019–1022, 2007.
[22]
G. S. Van Thiel, S. Sheehan, R. M. Frank et al., “Retrospective analysis of arthroscopic management of glenohumeral degenerative disease,” Arthroscopy, vol. 26, no. 11, pp. 1451–1455, 2010.
[23]
D. M. Weinstein, J. S. Bucchieri, R. G. Pollock, E. L. Flatow, and L. U. Bigliani, “Arthroscopic debridement of the shoulder for osteoarthritis,” Arthroscopy, vol. 16, no. 5, pp. 471–476, 2000.
[24]
D. L. Burgess, M. S. McGrath, P. M. Bonutti, D. R. Marker, R. E. Delanois, and M. A. Mont, “Shoulder resurfacing,” The Journal of Bone & Joint Surgery A, vol. 91, no. 5, pp. 1228–1238, 2009.
[25]
O. Levy and S. A. Copeland, “Cementless surface replacement arthroplasty of the shoulder. 5- to 10-year results with the Copeland mark-2 prosthesis,” The Journal of Bone & Joint Surgery B, vol. 83, no. 2, pp. 213–221, 2001.
[26]
O. Levy, L. Funk, G. Sforza, and S. A. Copeland, “Copeland surface replacement arthroplasty of the shoulder in rheumatoid arthritis,” The Journal of Bone & Joint Surgery A, vol. 86, no. 3, pp. 512–518, 2004.
[27]
S. R. Thomas, G. Sforza, O. Levy, and S. A. Copeland, “Geometrical analysis of Copeland surface replacement shoulder arthroplasty in relation to normal anatomy,” Journal of Shoulder and Elbow Surgery, vol. 14, no. 2, pp. 186–192, 2005.
[28]
M. Buchner, N. Eschbach, and M. Loew, “Comparison of the short-term functional results after surface replacement and total shoulder arthroplasty for osteoarthritis of the shoulder: a matched-pair analysis,” Archives of Orthopaedic and Trauma Surgery, vol. 128, no. 4, pp. 347–354, 2008.
[29]
D. S. Bailie, P. J. Llinas, and T. S. Ellenbecker, “Cementless humeral resurfacing arthroplasty in active patients less than fifty-five years of age,” The Journal of Bone & Joint Surgery A, vol. 90, no. 1, pp. 110–117, 2008.
[30]
R. H. Cofield, M. A. Frankle, and J. D. Zuckerman, “Humeral head replacement for glenohumeral arthritis,” Seminars in Arthroplasty, vol. 6, no. 4, pp. 214–221, 1995.
[31]
M. E. Torchia, R. H. Cofield, and C. R. Settergren, “Total shoulder arthroplasty with the Neer prosthesis: long-term results,” Journal of Shoulder and Elbow Surgery, vol. 6, no. 6, pp. 495–505, 1997.
[32]
W. N. Levine, M. Djurasovic, J. M. Glasson, R. G. Pollock, E. L. Flatow, and L. U. Bigliani, “Hemiarthroplasty for glenohumeral osteoarthritis: results correlated to degree of glenoid wear,” Journal of Shoulder and Elbow Surgery, vol. 6, no. 5, pp. 449–454, 1997.
[33]
F. A. Matsen III, “Early effectiveness of shoulder arthroplasty for patients who have primary glenohumeral degenerative joint disease,” The Journal of Bone & Joint Surgery A, vol. 78, no. 2, pp. 260–264, 1996.
[34]
P. M. Bonutti, R. J. Hawkins, and S. Saddemi, “Arthroscopic assessment of glenoid component loosening after total shoulder arthroplasty,” Arthroscopy, vol. 9, no. 3, pp. 272–276, 1993.
[35]
A. D. Boyd Jr., W. H. Thomas, R. D. Scott, C. B. Sledge, and T. S. Thornhill, “Total shoulder arthroplasty versus hemiarthroplasty: indications for glenoid resurfacing,” Journal of Arthroplasty, vol. 5, no. 4, pp. 329–336, 1990.
[36]
G. M. Gartsman, T. S. Roddey, and S. M. Hammerman, “Shoulder arthroplasty with or without resurfacing of the glenoid in patients who have osteoarthritis,” The Journal of Bone & Joint Surgery A, vol. 82, no. 1, pp. 26–34, 2000.
[37]
J. W. Sperling and R. H. Cofield, “Revision total shoulder arthroplasty for the treatment of glenoid arthrosis,” The Journal of Bone & Joint Surgery A, vol. 80, no. 6, pp. 860–867, 1998.
[38]
J. W. Sperling, R. H. Cofield, and C. M. Rowland, “Neer hemiarthroplasty and Neer total shoulder arthroplasty in patients fifty years old or less: long-term results,” The Journal of Bone & Joint Surgery A, vol. 80, no. 4, pp. 464–473, 1998.
[39]
W. N. Levine, C. R. Fischer, D. Nguyen, E. L. Flatow, C. S. Ahmad, and L. U. Bigliani, “Long-term follow-up of shoulder hemiarthroplasty for glenohumeral osteoarthritis,” The Journal of Bone & Joint Surgery, vol. 94, no. 22, pp. e1641–e1647, 2012.
[40]
D. M. Rispoli, J. W. Sperling, G. S. Athwal, C. D. Schleck, and R. H. Cofield, “Humeral head replacement for the treatment of osteoarthritis,” The Journal of Bone & Joint Surgery A, vol. 88, no. 12, pp. 2637–2644, 2006.
[41]
J. W. Sperling, R. H. Cofield, and C. M. Rowland, “Minimum fifteen-year follow-up of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged fifty years or younger,” Journal of Shoulder and Elbow Surgery, vol. 13, no. 6, pp. 604–613, 2004.
[42]
M. A. Wirth, R. S. Tapscott, C. Southworth, and C. A. Rockwood Jr., “Treatment of glenohumeral arthritis with a hemiarthroplasty: a minimum five-year follow-up outcome study,” The Journal of Bone & Joint Surgery A, vol. 88, no. 5, pp. 964–973, 2006.
[43]
T. B. Edwards, N. R. Kadakia, A. Boulahia et al., “A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: results of a multicenter study,” Journal of Shoulder and Elbow Surgery, vol. 12, no. 3, pp. 207–213, 2003.
[44]
D. Bryant, R. Litchfield, M. Sandow, G. M. Gartsman, G. Guyatt, and A. Kirkley, “A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder: a systematic review and meta-analysis,” The Journal of Bone & Joint Surgery A, vol. 87, no. 9, pp. 1947–1956, 2005.
[45]
T. J. Fox, A. Cil, J. W. Sperling, J. Sanchez-Sotelo, C. D. Schleck, and R. H. Cofield, “Survival of the glenoid component in shoulder arthroplasty,” Journal of Shoulder and Elbow Surgery, vol. 18, no. 6, pp. 859–863, 2009.
[46]
E. V. Cheung, J. W. Sperling, and R. H. Cofield, “Revision shoulder arthroplasty for glenoid component loosening,” Journal of Shoulder and Elbow Surgery, vol. 17, no. 3, pp. 371–375, 2008.
[47]
K. I. Bohsali, M. A. Wirth, and C. A. Rockwood Jr., “Complications of total shoulder arthroplasty,” The Journal of Bone & Joint Surgery A, vol. 88, no. 10, pp. 2279–2292, 2006.
[48]
N. Bonnevialle, B. Melis, L. Neyton et al., “Aseptic glenoid loosening or failure in total shoulder arthroplasty: revision with glenoid reimplantation,” Journal of Shoulder and Elbow Surgery. In press.
[49]
G. Walch, A. A. Young, P. Boileau, M. Loew, D. Gazielly, and D. Molé, “Patterns of loosening of polyethylene keeled glenoid components after shoulder arthroplasty for primary osteoarthritis: results of a multicenter study with more than five years of follow-up,” The Journal of Bone & Joint Surgery, vol. 94, no. 2, pp. 145–150, 2012.
[50]
K. Hamada, H. Fukuda, M. Mikasa, and Y. Kobayashi, “Roentgenographic findings in massive rotator cuff tears. A long-term observation,” Clinical Orthopaedics and Related Research, no. 254, pp. 92–96, 1990.
[51]
J. Guery, L. Favard, F. Sirveaux, D. Oudet, D. Mole, and G. Walch, “Reverse total shoulder arthroplasty: survivorship analysis of eighty replacements followed for five to ten years,” The Journal of Bone & Joint Surgery A, vol. 88, no. 8, pp. 1742–1747, 2006.
[52]
J. L. Franklin, W. P. Barrett, S. E. Jackins, and F. A. Matsen III, “Glenoid loosening in total shoulder arthroplasty. Association with rotator cuff deficiency,” Journal of Arthroplasty, vol. 3, no. 1, pp. 39–46, 1988.
[53]
G. R. Williams Jr. and C. A. Rockwood Jr., “Hemiarthroplasty in rotator cuff-deficient shoulders,” Journal of Shoulder and Elbow Surgery, vol. 5, no. 5, pp. 362–367, 1996.
[54]
R. G. Pollack, E. D. Deliz, S. J. McIlveen, E. L. Flatow, and L. U. Bigliani, “Prosthetic replacement in rotator cuff-deficient shoulders,” Journal of Shoulder and Elbow Surgery, vol. 1, no. 4, pp. 173–186, 1992.
[55]
J. Sanchez-Sotelo, R. H. Cofield, and C. M. Rowland, “Shoulder hemiarthroplasty for glenohumeral arthritis associated with severe rotator cuff deficiency,” The Journal of Bone & Joint Surgery A, vol. 83, no. 12, pp. 1814–1822, 2001.
[56]
P. Grammont, P. Trouilloud, J. P. Laffay, and X. Deries, “Etude et réalisation d’une nouvelle prothèse d’épaule,” Rhumatologie, vol. 39, pp. 407–418, 1987.
[57]
F. Sirveaux, L. Favard, D. Oudet, D. Huquet, G. Walch, and D. Molé, “Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders,” The Journal of Bone & Joint Surgery B, vol. 86, no. 3, pp. 388–395, 2004.
[58]
V. de Cupis, C. Chillemi, and M. Marinelli, “Grammont inverted prosthesis for the treatment of cuff tear arthropathy: a 6-year follow-up study,” Orthopedics, vol. 31, no. 5, p. 447, 2008.
[59]
P. Boileau, D. Watkinson, A. M. Hatzidakis, and I. Hovorka, “Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty,” Journal of Shoulder and Elbow Surgery, vol. 15, no. 5, pp. 527–540, 2006.
[60]
P. Boileau and D. Watkinson, “Reverse total shoulder arthroplasty for cuff tear arthropathy,” in Advanced Reconstruction Shoulder, J. D. Zuckerman, Ed., pp. 579–590, American Academy of Orthopaedic Surgeons, Rosemont, Ill, USA, 2007.
[61]
D. Nam, C. K. Kepler, A. S. Neviaser et al., “Reverse total shoulder arthroplasty: current concepts, results, and component wear analysis,” The Journal of Bone & Joint Surgery A, vol. 92, supplement 2, pp. 23–35, 2010.
[62]
G. M. Gartsman and T. B. Edwards, Eds., Shoulder Arthroplasty, Elsevier Saunders, Philadelphia, Pa, USA, 1st edition, 2008.
[63]
D. Molé and L. Favard, “Excentered scapulohumeral osteoarthritis,” Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Moteur, vol. 93, no. 6, supplement, pp. 37–94, 2007.
[64]
D. Cuff, R. Clark, D. Pupello, and M. Frankle, “Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency: a concise follow-up, at a minimum of five years, of a previous report,” The Journal of Bone & Joint Surgery A, vol. 94, no. 21, pp. 1996–2000, 2012.