Shoulder arthritis is a debilitating condition that can affect range of motion and cause pain and loss of function. In many cases, a standard shoulder replacement can be performed with excellent restoration of function and elimination of pain.
You may not be familiar with the term shoulder impingement, but you may have heard its more common name, “swimmer’s shoulder.” It’s an apt description, as swimmers have a greater chance of developing this condition because of the stress on joints and tendons characteristic of the sport. Other athletes such as baseball and tennis players may also develop shoulder impingement as a result of the repetitive swinging of the bat or racquet.
Shoulder arthritis is caused by a deterioration of cartilage that happens over time as a result of joint movement. Cartilage coats the inside of joints and in effect keeps the bones from rubbing together. The normal wear and tear of life, accidents, or the brisk tempo of sports and other physical activity, can contribute to the wearing down and loss of our cartilage and the development of arthritis.
Hip dysplasia is a condition that is rooted in the early years of life, but often does not fully impact joint function until adulthood. Also known as developmental dysplasia of the hip (DDH), it is a congenital defect that impedes normal development of the hip bones, and progressively interferes with joint function and mobility. This condition is thought to be due to an inherently loose hip joint in childhood. If left uncorrected, the hip socket develops an irregular, shallow, and upsloping shape that does not sufficiently cover the femoral head. Eventually, the round head of the femur begins to drift away from the shallow socket and may become completely dislocated. Hip dysplasia that is untreated can cause significant disability for patients including hip pain, labral tears, and progression to hip arthritis at a young age.
In our practice we deal with many rather obvious problems such as fractures and dislocations of the hip. Instability of the hip is a much more subtle condition. Instability occurs when the ball of the hip, the femoral head, is not maintained in a stable way within the hip socket. This can be due to a shallow joint, a condition called hip dysplasia, or due to hyperflexibility of the soft tissues with certain conditions. Instability can also occur from injury to the ligaments of the hip from trauma. The hard thing about instability is that the X-rays and even the MRIs can often look completely normal. Only by stressing and pushing on the femur and reproducing a patient’s feeling can we make the diagnosis of instability.
Like many joints in the body, the hip joint is a “ball and socket” system. The femoral head is the round top of the thigh bone that fits into the acetabular socket. For this system to work, the parts need to work together flawlessly, and there must be sufficient cartilage within the socket to promote smooth movement.