Orthopedics-Online

Osteoarthritis of the shoulder

Synonyms in a broader sense

Shoulder joint arthrosis, acromioclavicular joint arthrosis, AC joint arthrosis, collarbone, clavicle, acromion, shoulder joint, osteoarthritis ACG

introduction

The shoulder joint (Acromioclavicular joint, AC joint for short), is the joint between the shoulder roof (Acromion) and the collarbone (Clavicle). A lot of sport, physical work or after injuries can cause signs of wear and tear in this joint, which are known as osteoarthritis.

causes

The shoulder joint, between the collarbone and the acromion, is exposed to great mechanical shear stresses. For this reason, x-ray degenerative changes in the joint are often noticeable.

Even after an injury to the shoulder joint, e.g. a rupture of the joint capsule, degenerative changes in the joint and signs of wear and tear can occur.
Due to the high stress on the joint, the joint capsule and the bursa inside it can wear out over the years. The "buffer" between the two ends of the bone is gradually becoming smaller and can be completely worn out in the final stage (osteoarthritis of the shoulder). In this case, the ends of the bones freely rub against each other and wear off.

As a result, the joint space becomes narrower and the bone is remodeled so that new bony formations arise. If these grow upwards, they can come into contact with the tendons of the muscles that run there. Constant rubbing of the tendons on the bony protrusions can cause them to lose their function over time and thus accelerate the development of an osteoarthritis of the shoulder. The constant friction also leads to severe pain.

Appointment with a shoulder specialist

I would be happy to advise you!

Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of .

The shoulder joint is one of the most complicated joints in the human body.

The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.

Symptoms

With osteoarthritis of the shoulder joint there are often punctual pain in the shoulder joint, which can become worse through stress. Due to the bony changes in the shoulder joint, individual new bone formation can lead to different types of pain. If these new bone formations grow upwards, they can be seen from the outside as painful swellings above the shoulder joint.
New bone formation that grows downwards can irritate the tendons and bursa. These occur mainly in the upper arm and when the arm rotates.
Some patients describe the symptoms of ankle joint osteoarthritis as a pulling pain in the neck. The overall pain symptoms, however, are very different from one individual to the other and therefore cannot be generalized.

Type of pain

The pain is usually easy to localize by those affected. Usually the pain does not start until the shoulder is moved. The pain initially occurs with typical movements such as push-ups or overhead work.

The quality of the pain is usually described as sharp. In addition, if the tendons and ligaments are affected by the osteoarthritis, the pain can radiate into the upper arm or even towards the elbow. If the shoulder is inflamed, lying on the shoulder can also cause pain.

Diagnosis of ankle joint arthrosis

A suspected diagnosis of osteoarthritis of the shoulder can often be made by precisely describing the symptoms. However, further imaging procedures and a precise clinical examination are necessary for an exact diagnosis. When palpating, the doctor pays attention to swelling, tenderness and pain in the joint.

The imaging diagnosis includes

the X-ray
and or
an MRI of the shoulder (MRI of the shoulder)
and or
an ultrasound (Sonography).

In the X-ray in two planes, a narrowing of the joint space and bony protrusions growing into the joint space (Osteophytes) visible.
The narrowing of the joint space is also visible in the ultrasound examination, and capsule swelling and increased fluid in the joint can also be seen. Damage to the tendons under the shoulder joint and bursitis can also be seen.
Magnetic resonance imaging of the shoulder (MRT) offers an ideal assessment of the osteophytes that reach into the space under the acromioclavicular joint due to its very good resolution. The contact between the tendons and the protruding bones and the associated danger to the tendons can also be assessed.

therapy

First, local anesthetics and anti-inflammatory drugs can be injected into the joint space, which will relieve pain in the shoulder joint and relieve inflammatory swelling.
An osteoarthritis of the shoulder joint is usually only performed in exceptional cases. A resection arthroplasty is performed here. A few millimeters of the lateral collarbone or the joint are removed so that the joint space becomes wider again. The band structures are preserved so that there is no instability. The symptoms are often significantly better very quickly after the operation. Due to the invasiveness of the procedure, conservative therapy is always undertaken first.

Cortisone injections

With a cortisone injection, cortisone is injected directly into the shoulder joint, where the inflammation is located. The inflammation can be searched for and displayed in advance using an ultrasound. A cortisone injection should only be given in cases of severe osteoarthritis of the shoulder. This means that all other conservative measures, such as taking anti-inflammatory pain relievers, have not worked.

Even if the cortisone injection is successful, it should by no means be a long-term therapy. Cortisone has a strong anti-inflammatory effect, but it can cause surrounding structures such as muscles, tendons, bones and other tissue to wither (atrophy).

Further information:

Cortical syringe - areas of application and side effects
Cortisone therapy for joint diseases

Treatment with hyaluronic acid

To delay an operation further, injecting hyaluronic acid into the joint can be tried as an alternative to other conservative methods.

On the one hand, joint wear should be delayed. On the other hand, the hyaluron should lie like a buffer between the affected joint partners. The hyaluronic acid is supposed to replace the joint fluid, which is mostly lost due to the inflammation, and to make it easier for the joint partners to slide, so that pain is reduced and the joint can recover. Injections of hyaluronic acid is offered by many orthopedic surgeons, but is not a health insurance benefit and must be paid for by the patients themselves.

When do you need an operation?

Before each operation, the non-operative (conservative) therapy is exhausted. However, if there is no improvement or severe pain despite therapy, an operation should be considered.

Especially with young, sporty people, an operation may be the only way to maintain the usual or desired quality of life. A jointoscopy is usually carried out, whereby damaged and pain-causing joint surfaces are removed.

Which exercises can help?

Exercise is an important part of treating the shoulder joint osteoarthritis. The exercises ensure that pain is relieved and mobility is maintained.

The focus is on strengthening the muscles so that the shoulder joint is no longer stressed. A warm-up should take place before the exercises; shoulder circles are suitable for this.

In one possible exercise, the person concerned is sitting. The forearm is laid flat on a table or mat. The angle at the elbow joint should be 90 degrees. Now the forearm is pressed on the mat for several seconds and then relaxed again. This should be repeated 15 times and several times a day.

Even simple shoulder raises with arms hanging down on the sides of the body can improve the symptoms of ankle joint arthrosis. This exercise should also be performed 15 times several times a day. Which exercise is best for each individual should best be discussed with the doctor or physiotherapist.

You might also be interested in this topic:

Exercise for osteoarthritis

Summary

The joint arthrosis of the acromioclavicular joint, the so-called shoulder corner joint arthrosis, is a very common problem due to the high stress caused by sport, physical work or post-traumatic stress. Years of stress lead to a narrowing of the joint space and the formation of new bony protrusions, as a result of which the tendons and the joint space are worn out over time.

This leads to pain of varying degrees and can severely restrict mobility in the shoulder joint due to the pain. The diagnosis can be made with certainty through a physical examination and various imaging procedures.
However, the therapy options are very limited. For this reason, conventional therapeutic approaches such as injections of anti-inflammatory drugs and local anesthetics are first injected into the joint space. If this therapy does not provide sufficient relief from the symptoms, the joint space can be surgically enlarged. The disturbing new bone formation is also removed during the operation. However, if the tendons have already been attacked by the friction, only limited relief of the symptoms and restoration of functionality is possible.