Wednesday, July 2, 2014

The different faces of shoulder arthritis. Intra-operative pictures

The following case is an elderly woman with many years of pain and crepitus to the shoulder. Her active forward elevation was to 50 degrees with intact rotator cuff. The patient failed conservative treatment and elected to have a total shoulder replacement for her shoulder arthritis. Preoperative, intra-operative and postoperative images are shown below. Most of the time we find loss of articular cartilage and flattening of the humeral head. In this case the arthritic changes were cystic changes to the humeral head and glenoid. Of note the patient has no history of autoimmune disease or inflammatory arthropathy.

Preoperative on the right and postoperative image on the left

Left: Axillary view shows no dislocation. Right: Erosive changes to humeral head and glenoid are seen

Cystic changes to the humeral head were seen intra-operatively

No cartilage was found on the glenoid