Mild glenohumeral arthritis is often manageable with a regimen of:
Rest
NSAIDS (non-steroidal anti-inflammatory medicines) - such as ibuprofen or naproxen
Exercises to increase range of motion and strength
Mild to moderate glenohumeral arthritis pain is often effectively controlled by using any one or a combination of the following treatments:
Corticosteroid injections (cortisone shots) may be recommended for more severe cases that do not respond to NSAIDS. A concentrated dose of anti-inflammatory medicine is injected directly into the joint and can be safely used to manage most patients' pain. It does not cure the disease, however, and not all patients respond well to the injections. Eventually, corticosteroids lose their effectiveness for most patients' pain.
Glucosamine and chondroitin are non-prescription supplements that may help neutralize the destructive enzymes associated with osteoarthritis. They may also serve as building blocks for new cartilage formation. These compounds, which are available separately or in combination, have been shown to decrease arthritis pain in some clinical trials; however, more research is needed to evaluate the full extent of their effectiveness.
Viscosupplementation therapy improves the cushioning of the joint surfaces and has gained popularity in the last few years. Hyaluronic acid is injected directly into the joint in order to improve joint lubrication and reduce friction during movement. Hyaluronic compounds are generally safe although there have been reports of inflammatory reactions in patients treated with some preparations. Most of the studies on viscosupplementation have been done on the knee, so it is less clear what effects this type of treatment will have on the arthritic shoulder.
When severe shoulder arthritis pain is unmanageable with non-operative measures, surgical treatment may be recommended.
Even with the closest attention to detail, surgical complications may occur. Debridement surgery is typically less complex than arthroplasty. However, as with arthroplasty, the potential complications of bleeding, nerve injury, and infection are present.
Some of the more common complications are:
Infection - Perioperative antibiotics (given before and after surgery) and current intraoperative procedures have reduced infection rates in arthroplasty to less than 1%. If the infection is caught early, aggressive antibiotic treatment may save the components. A chronic infection that has been present for more that 6-12 weeks generally requires removal of the infected implant.
Blood loss - Although not usually considered a complication, blood loss is common during shoulder replacement surgery and a transfusion may be required. To avoid the concerns of disease transmission from a blood bank, the patient may choose to donate blood for use during the surgery, should it be necessary. Even though there are legitimate concerns about banked blood, the current blood available is extremely safe with very low incidences of disease transmission.
Nerve injury - Nerve injuries that occur during shoulder replacement surgery are usually temporary, with near normal function returning over time.
Component failure - This problem is more common with the glenoid component of a total shoulder arthroplasty. Usually, but not always, the loose glenoid component requires surgical removal.
