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Omarthrosis – Shoulder Osteoarthritis: Causes & Treatment

Omarthrosis is a degenerative disease of the shoulder joint in which the articular cartilage gradually breaks down, causing pain, stiffness, and restricted movement.

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Things worth knowing about "Omarthrosis"

Omarthrosis is a degenerative disease of the shoulder joint in which the articular cartilage gradually breaks down, causing pain, stiffness, and restricted movement.

What is Omarthrosis?

Omarthrosis (also known as shoulder osteoarthritis or glenohumeral osteoarthritis) is a degenerative joint disease affecting the shoulder. It involves the progressive breakdown of the articular cartilage between the head of the humerus (upper arm bone) and the glenoid cavity of the scapula (shoulder blade). As the cartilage wears away, bone begins to rub against bone, leading to pain, stiffness, and reduced range of motion. Omarthrosis is one of the most common shoulder conditions in older adults.

Causes

Omarthrosis is classified into two main types:

Primary Omarthrosis

Primary omarthrosis has no identifiable underlying cause and develops due to age-related wear and tear of the cartilage. Risk factors include:

Advanced age
Genetic predisposition
Obesity (increased mechanical load on the joint)
Long-term overuse of the shoulder (e.g., heavy manual labor or competitive sports)

Secondary Omarthrosis

Secondary omarthrosis develops as a result of another condition or injury, such as:

Shoulder fractures or dislocations
Rotator cuff tears
Inflammatory joint diseases such as rheumatoid arthritis or gout
Avascular necrosis of the humeral head
Congenital joint deformities

Symptoms

The symptoms of omarthrosis typically develop gradually and worsen over time:

Pain in the shoulder, especially with movement and loading
Rest pain or night pain in advanced stages
Morning stiffness of the shoulder joint
Restricted range of motion (e.g., difficulty raising or rotating the arm)
Audible or palpable grinding and clicking sounds in the joint (crepitus)
Swelling and warmth of the joint during inflammatory flare-ups
Muscle atrophy around the shoulder due to protective posture

Diagnosis

The diagnosis of omarthrosis is established by a physician through several examinations:

Medical history and physical examination: The doctor assesses the patient's history, pain level, and range of motion.
X-ray: The most important imaging method. It reveals joint space narrowing, bone spurs (osteophytes), and subchondral sclerosis.
Ultrasound: Used to evaluate soft tissues and tendon damage.
Magnetic resonance imaging (MRI): Provides detailed images of cartilage, tendons, and surrounding structures, especially in complex cases.
Blood tests: To rule out inflammatory or rheumatic conditions.

Treatment

Treatment of omarthrosis depends on the severity of the condition and the patient's symptoms. Options are divided into conservative (non-surgical) and surgical approaches.

Conservative Treatment

Pain management: Analgesics such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs, e.g., ibuprofen, diclofenac) reduce pain and inflammation.
Physiotherapy: Targeted exercises maintain joint mobility, strengthen the shoulder muscles, and reduce mechanical stress on the joint.
Heat and cold therapy: Heat relaxes muscles; cold applications reduce acute inflammation.
Corticosteroid injections: Direct injections into the shoulder joint can provide significant short-term relief from pain and inflammation.
Hyaluronic acid injections: A gel-like lubricant injected into the joint (evidence of effectiveness is debated).
Weight management and adaptation of daily activities to reduce joint load.

Surgical Treatment

When conservative measures fail to provide sufficient relief, surgical interventions may be considered:

Shoulder arthroscopy: A minimally invasive procedure to remove bone spurs or loose joint bodies.
Shoulder replacement (total shoulder arthroplasty): In advanced stages, the damaged shoulder joint can be replaced with an artificial implant. Depending on the extent of damage, an anatomical or an reverse shoulder prosthesis may be used.

Prognosis

Omarthrosis is a chronic, progressive condition that cannot be cured. However, early and consistent treatment can significantly slow disease progression and improve quality of life. Many patients benefit long-term from a combination of physiotherapy, pain management, and lifestyle adjustments. In severe cases, shoulder replacement surgery often allows patients to regain substantial function and live with minimal pain.

References

Norris TR, Iannotti JP: Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study. Journal of Shoulder and Elbow Surgery, 2002.
Buckwalter JA, Saltzman C, Brown T: The impact of osteoarthritis. Clinical Orthopaedics and Related Research, 2004.
World Health Organization (WHO): Musculoskeletal conditions -- Osteoarthritis. Available at: www.who.int (accessed 2024).

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