Cartilage Injury & Repair

Shoulder Cartilage Resurfacing & Restoration

For many patients, shoulder pain and immobility affects every aspect of their daily lives. Many will undergo surgery for a total shoulder joint replacement which involves completely replacing the head of the upper arm bone, the humerus.

Another alternative, especially for younger, more active patients, is shoulder resurfacing. Shoulder resurfacing surgery is a less invasive, bone preserving surgery than total joint replacement. In resurfacing, the arthritic bone surface is smoothed and covered with a prosthetic cap over the end of the arm bone.

What is Arthritis?

Arthritis is a general term covering numerous conditions where the joint surfaces wear out. The joint surface is covered by a smooth articular surface called cartilage that allows pain free movement in the joint. This surface can wear out for several reasons. Often the definite cause is not known.

When the articular cartilage wears out, the bone ends rub on one another and cause pain. There are numerous conditions that can cause arthritis and often the exact cause is never known. In general, but not always, it affects people as they get older. This type of arthritis is called “wear and tear” arthritis or Osteoarthritis.

Other causes of arthritis include:

  • Growth abnormalities may lead to premature arthritis.
  • Trauma (fracture)
  • Increased stress from overuse
  • Avascular necrosis (loss of blood supply)
  • Infection
  • Connective tissue disorders
  • Inflammatory diseases such as Rheumatoid arthritis

In an arthritic shoulder

  • The cartilage lining is thinner than normal or completely absent. The degree of cartilage damage and inflammation varies with the type and stage of arthritis.
  • The capsule of the arthritic shoulder is swollen
  • The joint space is narrowed and irregular in outline; this can be seen in an X-ray image.
  • Bone spurs or excessive bone can also build up around the edges of the joint.

The combinations of these factors make the arthritic shoulder stiff and limit activities due to pain or fatigue.

Shoulder resurfacing and restoration is an alternative to total shoulder replacement. Shoulder resurfacing involves replacing the diseased surface of the joint instead of the entire joint. It is therefore less traumatic and invasive as well as bone preserving. Some advantages of resurfacing include:

  • No osteotomy (bone cutting) is done, so more bone is preserved
  • Shorter operating time
  • Easy to revise to total shoulder replacement in future if needed
  • Lower risk of fractures around the prosthesis