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Osteoarthritis in Young Patients and Current Treatments

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Abstract

The articular cartilage of the shoulder is not endowed with intrinsic repair abilities; therefore in the presence of diseases, like instability or cuff injury, even minor lesions may rapidly lead to early glenohumeral joint arthritis. The presence of cartilage lesions is not unusual even in young patients, and often they are found during arthroscopic procedures in several pathologic conditions. Less common conditions include glenoid dysplasia and osteochondritis dissecans. The varying thicknesses of the joint cartilage and the different resistance properties of the subchondral bone result in lesions of different depths and widths depending on the resistance offered by the articular surface. Minor cartilage lesions associated with rotator cuff or glenohumeral ligament damage will induce topographically different types of stress on the various areas of the articular surface. Recent and older research findings showed in the shoulder as in the knee, a correlation between cartilage wear and lesion site and between site and symptoms. Several conservative options available to manage shoulder arthritis are directed to alleviate pain, reduce inflammation, and, especially, halt or at least slow down the evolution of arthritis. Such therapies entail changes in lifestyle and systemic and topical drug administration. Viscosupplementation using hyaluronic acid may constitute a helpful treatment option in patients who have shoulder osteoarthritis with an intact rotator cuff, while lesser satisfactory results have been showed in case of rotator cuff tears or advanced osteoarthritis. Several surgical options are available to manage primary shoulder arthritis, including simple arthroscopic joint debridement and more complex techniques such as resurfacing using the fascia lata or meniscus, osteochondral autologous transplantation, resurfacing arthroplasty, and total arthroplasty.

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Author information

Authors and Affiliations

  1. Department of Orthopedics, St. Luke’s Hospital, Bielsko-Biała, Poland

    Roman Brzóska MD, PhD, Adrian Błasiak MD & Wojciech Solecki MD

  2. Department of Orthopedics, Haga Hospital, Hague, The Netherlands

    Polydoor E. Huijsmans & Catherine van der Straeten

  3. Department of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA

    Anthony Miniaci MD, FRCSC

  4. Unit of Shoulder Surgery, “D. Cervesi” – Hospital, Cattolica, Italy

    Giuseppe Porcellini

Authors
  1. Roman Brzóska MD, PhD
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  2. Adrian Błasiak MD
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  3. Polydoor E. Huijsmans
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  4. Anthony Miniaci MD, FRCSC
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  5. Giuseppe Porcellini
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  6. Wojciech Solecki MD
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  7. Catherine van der Straeten
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Corresponding authors

Correspondence to Roman Brzóska MD, PhD , Polydoor E. Huijsmans , Anthony Miniaci MD, FRCSC or Giuseppe Porcellini .

Editor information

Editors and Affiliations

  1. Istituti Ortopedico Rizzoli Clinica Ortopedica Traumatologica III, Bologna, Italy

    Stefano Zaffagnini

  2. Klinikum Brandenburg Orthopädie und Unfallchirurgie, Brandenburg an der Havel, Germany

    Roland Becker

  3. Department of Orthopedic Surgery, Academic Medical Centre Amsterdam University of Amsterdam, Amsterdam, The Netherlands

    Gino M.M.J. Kerkhoffs

  4. Clínica Espregueira Mendes, Porto, Portugal

    João Espregueira Mendes

  5. Orthopedic Surgery, University of Amsterdam Academic Medical Centre, Amsterdam, The Netherlands

    C. Niek van Dijk

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Brzóska, R. et al. (2014). Osteoarthritis in Young Patients and Current Treatments. In: Zaffagnini, S., Becker, R., Kerkhoffs, G., Espregueira Mendes, J., van Dijk, C. (eds) ESSKA Instructional Course Lecture Book. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-53983-1_1

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  • DOI: https://doi.org/10.1007/978-3-642-53983-1_1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-53982-4

  • Online ISBN: 978-3-642-53983-1

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