Glenohumeral Arthritis
What Is the Anatomy of the Glenohumeral Joint?
The glenohumeral joint, commonly known as the shoulder joint, is a ball-and-socket joint formed by the head of the humerus (upper arm bone) and the glenoid cavity of the scapula (shoulder blade). The joint allows a wide range of motion, making it one of the most mobile joints in the body. Smooth cartilage covers both joint surfaces, allowing pain-free movement. The joint capsule, labrum, ligaments, and surrounding rotator cuff muscles work together to provide stability and control throughout motion.
How Does Glenohumeral Arthritis Occur?
Glenohumeral arthritis occurs when the articular cartilage that lines the ball and socket of the shoulder gradually wears down, leading to bone-on-bone contact, inflammation, and pain. Causes include:
Primary osteoarthritis due to age-related cartilage degeneration.
Post-traumatic arthritis following a previous fracture or dislocation.
Inflammatory arthritis such as rheumatoid arthritis.
Cuff tear arthropathy caused by long-standing rotator cuff deficiency.
Avascular necrosis leading to collapse of the humeral head.
As the cartilage deteriorates, the joint becomes stiff and painful, and bone spurs (osteophytes) may develop.
What Is the Long-Term Consequence of Having Glenohumeral Arthritis?
If left untreated, glenohumeral arthritis can result in:
Chronic shoulder pain and stiffness.
Progressive loss of motion, especially with overhead or rotational activities.
Reduced functional use of the arm.
Night pain that interferes with sleep.
Progressive deformity of the shoulder joint.
How Does Glenohumeral Arthritis Get Diagnosed?
Diagnosis is based on a combination of clinical history, physical examination, and imaging:
History of gradual onset of shoulder pain, stiffness, and functional decline.
Physical examination reveals reduced range of motion, crepitus (grinding), and weakness.
X-rays showing joint space narrowing, osteophyte formation, and subchondral sclerosis or cysts.
MRI or CT scans may be used to evaluate cartilage wear, bone quality, and any associated rotator cuff pathology.
What Are the Indications for Treating Glenohumeral Arthritis Non-Operatively?
Non-operative management is typically the first line of treatment and is appropriate for:
Mild to moderate symptoms that do not significantly limit daily activities.
Early arthritis with preserved motion.
Patients who are medically unfit or wish to avoid surgery.
Low-demand individuals whose pain can be managed conservatively.
Treatment options include maintaining motion and strength, anti-inflammatory medications, corticosteroid injections, and activity modification.
What Are the Indications for Treating Glenohumeral Arthritis Operatively?
Surgical management is considered in patients with:
Severe pain that interferes with sleep or daily activities.
Advanced arthritis with joint space loss and bone changes.
Failure of non-operative management after an adequate trial period.
Functional limitation or deformity that affects quality of life.
Surgical options depend on the patient’s age, activity level, and rotator cuff status. These may include arthroscopic debridement for early disease, hemiarthroplasty (replacement of the humeral head only), anatomic total shoulder arthroplasty, or reverse total shoulder arthroplasty.
