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Osteoarthritis following shoulder instability.

Robert H Brophy1, Robert G Marx

  • 1Hospital for Special Surgery, 535 East 70(th) Street, New York, NY 10021, USA. brophyr@hss.edu

Clinics in Sports Medicine
|January 8, 2005
PubMed
Summary

Shoulder instability may lead to glenohumeral osteoarthritis and increase the need for shoulder arthroplasty. Further research is needed to clarify this link and guide treatment for patients with instability-related arthritis.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Rheumatology

Background:

  • The relationship between shoulder instability and glenohumeral osteoarthritis (GHOA) is not fully understood.
  • Chondral damage is linked to instability, suggesting a potential pathway to symptomatic GHOA and arthroplasty.
  • Patients with instability history may face an elevated risk of developing GHOA.

Purpose of the Study:

  • To explore the association between shoulder instability and the development of glenohumeral osteoarthritis.
  • To investigate the risk of symptomatic osteoarthritis and need for shoulder arthroplasty in patients with a history of instability.
  • To define the relationship between early arthritic changes and clinically significant GHOA.

Main Methods:

  • Literature review and analysis of existing studies on shoulder instability and GHOA.
  • Examination of the impact of surgical interventions for instability on GHOA development.
  • Evaluation of treatment outcomes for total shoulder replacement in patients with instability-related GHOA.

Main Results:

  • Shoulder instability is associated with chondral damage and an increased risk of symptomatic glenohumeral osteoarthritis.
  • Surgical procedures for instability can elevate GHOA risk if they restrict external rotation or involve migrating hardware.
  • Total shoulder replacement is a viable treatment for advanced GHOA in unstable shoulders, with generally satisfactory but lower outcomes compared to primary GHOA.

Conclusions:

  • Shoulder instability is a significant risk factor for developing glenohumeral osteoarthritis.
  • Surgical management of instability requires careful consideration to minimize iatrogenic arthritis.
  • Total shoulder replacement offers a treatment option for advanced GHOA secondary to instability, though outcomes warrant further investigation.

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