What is shoulder osteoarthritis?

Shoulder osteoarthritis, also called omarthrosis, corresponds to progressive wear of the articular cartilaginous surfaces. Under normal conditions, the cartilage of the humeral head slides against that of the glenoid of the scapula, allowing fluid and painless movements.

When the cartilage disappears, the bone rubs directly against the bone, generating pain and functional discomfort. The integrity of the rotator cuff conditions the optimal therapeutic choice.

Main causes

Progressive wear

Repeated stress (manual work with loads above the shoulder, contact sports) favor osteoarthritis.

Trauma

Fractures affecting the articular surfaces (humeral head, glenoid) can lead to osteoarthritis.

Osteonecrosis

Interruption of bone vascularization (dislocations, long-term corticosteroids) leading to bone death.

Rotator cuff rupture

Eccentricity of the humeral head causes abnormal friction and cartilaginous wear.

Diagnosis and evaluation

Clinical examination

• Pain: related to bone-on-bone friction and inflammation, often increased with active movements
• Functional impairment: global or sectorial amplitude reduction according to location
• Night awakenings: possible in case of significant inflammation

Imaging examinations

X-ray

Key examination showing joint space narrowing, deformations, osteophytes

MRI/Arthro-CT

Comprehensive assessment for early stages and surgical planning

Therapeutic options

Medical treatment

• Analgesics and anti-inflammatories as needed
• Intra-articular injections (corticosteroids, viscosupplementation)
• Adapted physiotherapy to optimize function

Surgical treatment

Shoulder prosthesis placement is considered according to age, painful/functional discomfort and rotator cuff condition.

Anatomical prosthesis

Preferred in centered osteoarthritis with intact rotator cuff. Stemless versions to preserve bone.

Reverse prosthesis

Indicated in eccentric osteoarthritis with rotator cuff rupture. Reverses biomechanics to mobilize the shoulder.

Learn more about shoulder prostheses →

Post-operative rehabilitation

• Immobilization: Splint 4-6 weeks (day and night except care/exercises)
• Rehabilitation: Started early and progressing according to healing (4-6 months)
• Return to activities: Daily activities around 2 months, sports around 4 months

Specificities: After anatomical prosthesis, subscapularis protection. After reverse prosthesis, deltoid protection in initial phase.

Possible complications