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Exploring Options to Treat Advanced Shoulder Arthritis

September 25, 2017

About 50 million Americans have been diagnosed with arthritis, a disease that causes pain and inflammation in the joints. Many of these patients have pain in the shoulder. I recommend gentle stretches, physical therapy and oral medications as first-line treatment. For some patients, shoulder replacement surgery may be an effective way to relieve pain when medicine and other treatments do not work.

I have spent many years studying how to best treat shoulder arthritis. I completed my five-year orthopaedic surgery residency at Orlando Health, followed by a fellowship in shoulder and elbow surgery at the University of Washington. My fellowship had a significant focus on treating shoulder arthritis, including both reverse shoulder replacement and anatomic total shoulder replacement. 

Shoulder osteoarthritis occurs when the smooth cartilage that covers the surface of the bones is damaged and begins to wear away, causing the bones to rub together. The bone on bone contact causes grinding, stiffness and pain in the shoulder. Osteoarthritis is the most common form of shoulder arthritis, while inflammatory arthritis and rheumatoid arthritis can also cause this condition. Anti-inflammatory medications and physical therapy may help some patients, but surgery is often the best option for patients with severe shoulder joint pain. Shoulder replacement surgery allows many patients each year to return to activities they enjoy with less pain and stiffness.

Research is very important to me because the results can help not only my own patients, but also patients around the world. Recently, I performed a research study on anatomic total shoulder replacements. This study was published as a peer-reviewed article in the journal Clinical Orthopaedics and Related Research with my fellowship team. The study looked at outcomes after total shoulder replacement for patients with osteoarthritis and other types of degenerative joint diseases of the ball and socket joint (glenohumeral joint).

Our research team compared outcomes after anatomic shoulder replacement for patients with advanced bone deformity of the socket (glenoid) with outcomes for patients without advanced bone deformity of the socket. The results showed that anatomic total shoulder replacement with a bone-preserving approach without special implants or bone grafts had similar outcomes for patients with and without advanced bone deformity.

Treatment in the operating room is decided for each unique patient depending on the degree of their arthritis. Our study is important because when the bone of the socket of the shoulder wears out, management in the operating room can be very challenging. The techniques used in the journal article (a bone-preserving approach without special implants or bone grafts) suggest that each patient’s shoulder anatomy must be carefully examined to determine which treatment is best. In certain cases, even with an advanced bone defect of the socket, anatomic total shoulder replacement surgery may still be a good treatment option.

More research is needed to determine how to best manage severe arthritis of the shoulder. I am actively involved with the American Shoulder and Elbow Surgeons and I’m committed to advancing the field of orthopaedic surgery with ongoing research initiatives. It is my hope that my research and the work of many others in this field can advance treatment options for patients and provide relief for those who have to cope with this challenging degenerative disease. 

For more information, please contact my office at (321) 842-0060 if you have any questions or would like to schedule an appointment.


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