Navigation Links
Shoulder arthritis? What patients need to know before treatment
Date:7/15/2010

The American Academy of Orthopaedic Surgeons (AAOS) has approved and released an evidence-based clinical practice guideline on "The Treatment of Glenohumeral Joint Osteoarthritis." This major joint in the shoulder the ball and socket joint is sometimes affected by osteoarthritis, causing pain, loss of function, and reduced quality of life.

According to Rolando Izquierdo, MD, chair of the Academy work group on glenohumeral joint osteoarthritis, shoulder replacement surgery has been routinely performed since the 1970s for patients with advanced osteoarthritis of the shoulder. A review of the literature supports the use of both total and partial shoulder replacement for this population.

"The literature suggests, though, that pain relief is better and motion is better with total joint replacements than with partial replacements," says Dr. Izquierdo. "We also have to consider the 14 percent failure rate of partial replacements, which then require revision to total replacements. This revision is required due to progressive arthritis and pain.

"Because of a scarcity of high quality prospective studies, however, surgeons have few measures to support non-operative therapies for treating osteoarthritis of the shoulder," he adds.

The final treatment guidelines for treating glenohumeral joint osteoarthritis contain 16 recommendations. These include both operative and non-operative treatment options. Some important recommendations include the following:

  • One industry-supported study demonstrated that viscosupplementation shows a statistically significant benefit in pain relief, range of motion, and quality of life in patients with osteoarthritis of the shoulder. Essentially, viscosupplementation is a synthetic reproduction of a naturally occurring joint fluid that lubricates joints. Doctors inject synthetically created molecules, similar to the natural joint fluid, into an arthritic joint. Viscosupplementation is, therefore, an option when treating patients with glenohumeral joint osteoarthritis. The U.S. Food and Drug Administration (FDA) considers viscosupplementation an implant. While they approved the use of this procedure for treating knees in 1997, they have not yet approved this treatment for use in shoulders.

  • Surgeons should routinely take preventive steps to reduce the risk of potentially catastrophic complications caused by blood clots during and immediately following surgery. Exercises to increase blood flow and blood-thinning medications can also help avoid blood clots, as well. The Academy work group reached consensus with this recommendation, believing that the risk of not taking these preventive actions outweighs the risk of taking them.

The work group found a lack of quality prospective literature exists for recommending for or against the following treatments for osteoarthritis of the glenohumeral joint:

  • Drug therapy;
  • Injectable steroids; or
  • Arthroscopy (a surgical procedure surgeons sometimes use to diagnose and treat problems inside a joint).

Further, despite an exhaustive review of the literature, not a single study exists to support the use of physical therapy either for treating osteoarthritis of the shoulder or for treatment after replacement, Dr. Izquierdo says.

"There is a great variety in the types of therapies utilized, but very little guidance. It would be nice to have some data by a physical therapist or orthopaedic surgeon, but the studies have not been done."

The Centers for Disease Control and Prevention reports that more than 51 million Americans have been diagnosed with some form of arthritis. Shoulder replacements are the third most common joint replaced, following hips and knees.

While Dr. Izquierdo specializes in shoulder replacements, performing a high volume each year, most surgeons replace far fewer shoulders than hips or knees, he says. In fact, 75 percent of all shoulder replacements are done by non-specialists who perform two or fewer shoulder replacements a year. An option for reducing immediate post-operative complication rate, therefore, is for patients to avoid shoulder replacement by surgeons performing fewer than two shoulder replacements a year.

"One important take home message for a patient considering shoulder replacement therapy is to find a an orthpaedic surgeon who is trained in shoulder replacements to reduce immediate post-operative complication rates.

"These are the first guidelines for treating osteoarthritis of the glenohumeral joint," says Dr. Izquierdo, "There is minimal data currently available related to non-operative management of osteoarthritis of this joint. We are hoping these guidelines will stimulate further research to fill some of the void in the literature that currently exists for managing glenohumeral joint osteoarthritis."


'/>"/>

Contact: Lauren Pearson
pearson@aaos.org
847-384-4031
American Academy of Orthopaedic Surgeons
Source:Eurekalert

Related medicine news :

1. Patients Sponsor Their Chiropractors to Attend Frozen Shoulder Treatment Seminar
2. Henry Ford Hospital study: Shoulder function not fully restored after surgery
3. Shoulder Dislocations a Sports Hazard
4. Young Men and Elderly Women at Biggest Risk for Shoulder Dislocations
5. Girl Softball Players Suffering More Shoulder Injuries
6. Knee arthritis? Flexible options can help keep you active
7. New research explores relief for xerostomia cancer patients
8. Prediction tool helps estimate local recurrence in patients with noninvasive breast cancer
9. Interferon might help asthma patients breathe easier, UT Southwestern study suggests
10. Emotions May Be Blunted in Alzheimers Patients
11. Can Self-Hypnosis Help Tourette Patients Control Tics?
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... ... technology to revolutionize the emergency ambulance transport experience for the millions of people ... how Uber has disrupted the taxi industry through the use of technology. Now, ...
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, a Media ... give their videos a whole new perspective by using the title layers in ... Studios. , ProSlice Levels contains over 30 Different presets to choose from. ...
(Date:6/25/2016)... ... 2016 , ... Experts from the American Institutes for Research ... June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR experts ... planning, healthcare costs and patient and family engagement. , AIR researchers will be ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , ... Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. , ... our new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First ...
(Date:6/25/2016)... ... ... Conventional wisdom preaches the benefits of moderation, whether it’s a matter of ... too high can result in disappointment, perhaps even self-loathing. However, those who set the ... Research from PsychTests.com reveals that behind the tendency to set low expectations ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 The vast majority ... outpatient dialysis facility.  Treatments are usually 3 times a ... per visit, including travel time, equipment preparation and wait ... but especially grueling for patients who are elderly and ... skilled nursing and rehabilitation centers for some duration of ...
(Date:6/23/2016)... , June 23, 2016  Experian ... integrating and transforming the patient payment and ... several innovative new products and services that ... its revenue cycle offerings. These award-winning solutions ... efficient workflows, remain compliant in an ever-changing ...
(Date:6/23/2016)...  The National Pharmaceutical Council (NPC) today announced ... research organization as its newest member.  ... president and chief scientific officer, Mallinckrodt Pharmaceuticals, will ... Board of Directors. ... us in support of our efforts to conduct ...
Breaking Medicine Technology: