Shoulder Arthritis

Patient Stories

I am 65 years old and a life-long baseball and New York Mets fan. I’ve played baseball since I was seven, from little league through high school and college. I even experienced a bit of semi-professional baseball. I was a catcher, and always loved it. After a brief time playing softball in my thirties, I thought I was done with playing… Read more “Matt Breitenbach”

Matt Breitenbach

New York, NY

I am a dancer. It is my life’s passion. I was a senior in college at Northeastern University when my life changed in an instant. I was in my last semester, excited about my upcoming trips to Ireland to host a dance competition and then on Spring break to Mexico with my best friends. It was going to be great.… Read more “Bianca Smith”

Bianca Smith

Rutherford, NJ

When my experience with Hospital for Special Surgery first began, I was in a poor position mentally and physically, and my outlook on things weren’t the best. I had been competitively playing soccer in the Tri-State area since I was four-years-old. My soccer career included playing competitively in the highest division of the Monmouth and Ocean County (NJ) Soccer Association… Read more “Thomas Guardino”

Thomas Guardino

Brick, NJ

I’m a runner for over 20 years and after I ran the 2011 NYC Half Marathon, I started feeling some discomfort in my right knee, but I did not put too much attention. I went to see an orthopedic MD in Astoria and after an MRI and x-rays, he told me that my days as a runner were over, and… Read more “Viviana Denig”

Viviana Denig

Sunnyside, NY

I just wanted to take a moment and share my story and wonderful experience with The Women’s Sports Medicine Center and Doctor Sabrina Strickland at Hospital for Special Surgery. As you can see, I am not “local” to NYC. It is an effort to come to Manhattan, but the effort it well worth it. I have had a lifetime of… Read more “Paulette Gangemi”

Paulette Gangemi

Lambertville, NJ

A family member had been treated by Dr. Beth Shubin Stein for many years for arthritis in her knee. When I fell on ice last January I was unable to move my right arm and had intense pain in my arm and shoulder. I could not work at my company because of the injury. I made an appointment with Dr.… Read more “Robert Corvalan”

Robert Corvalan

Hampton Bays, NY

In high school I participated in many sports but my favorite two were soccer and track and field. During my high school career I experienced 3 shoulder dislocations but never looked into them. Upon being recruited to a collegiate track and field team, I went from being a hurdler and jumper to a heptathlete/pentathlete (7/5 event athlete). I had to… Read more “Isabella Bjorkeson”

Isabella Bjorkeson

Berkeley Heights, NJ

My name is Kim Pearson and I have never felt more cared for than during my visits to HSS. By day I am a special education teacher and group exercise instructor. However my hobby and passion in life is being a fitness competitor. I train 6 days a week and have worked my way up to the national level. One… Read more “Kim Pearson”

Kim Pearson

Stamford, CT

I’ve played basketball and/or run for my entire life, and in recent years have run 5Ks and marathons with friends.In training for the Berlin Marathon, I injured my knee, which Dr. Shubin Stein diagnosed as a complex tear of the posterior horn of my left menial meniscus. It hurt to walk and it hurt to straighten my leg, so running… Read more “Niko Pfund”

Niko Pfund

New York, NY

Since adolescence, I have had knee pain and subluxation and many knee surgeries. Knee pain was a part of my life for over twenty years, but it became increasingly worse to the point where I had episodes of significant swelling every other week. It began interfering with my work, my commute, and limited my activities with my family. I was… Read more “Maureen Suhr”

Maureen Suhr

Merrick, NY

I first injured myself playing basketball when I had just turned eleven years old. I was side shuffling to block a shot when my right knee locked and I fell down, dislocating my patella. I did not know what happened and when I was told I would be out of sports for some time, I was devastated. Physical therapy and… Read more “Katherine Trumble”

Katherine Trumble

Tinton Falls, NJ

I separated my right shoulder in 1995, the Dr. said the only that would help was time (and painkillers temporarily). It got somewhat better with time. Then worse. By 2011, not being able to reach across my desk at work to answer the phone, I sought help. The Drs. out on eastern LI kept giving me cortisone shots, to no… Read more “Barbara Jean Smith”

Barbara Jean Smith

Laurel, MD

I first came to Hospital for Special Surgery (HSS) in early 2000. Soon after, I began running marathons. Through HSS, I came to better understand my running biomechanics. In particular, I discovered that my running pattern creates excessive instability upon foot strike. As a result, I have experienced a myriad of injuries, including stress fractures, bursitis, tendonitis, etc. A freak… Read more “Catherine Karas”

Catherine Karas

Ridgewood, NJ

I saw Dr. Beth Shubin Stein after consulting with a surgeon locally in Mount Kisco. I had a torn meniscus and was in a great deal of discomfort. The local surgeon suggested I get surgery right away and told me “you will never get better without surgery with the type of tear you have.” I was discouraged for two reasons:… Read more “Teresa Saputo-Crerend”

Teresa Saputo-Crerend

Bedford Corners, NY

I would first like to take the time to thank Dr. Beth Shubin Stein and her staff for giving me the best possible treatment and experience I could have hoped for. Not only did Dr. Shubin Stein fix my knee, but she got me back running in the shortest time possible! While running my first full marathon in Disney World… Read more “Stephanie VandenBerg”

Stephanie VandenBerg

Northfield, NJ

I came to HSS to determine whether or not I needed surgery. I saw two doctors and found that each felt differently as to whether or not I needed surgery. I also went for a third recommendation from a PT–a director at another well-known institution. Since I also know that surgeries in the past have always been difficult for me-I… Read more “Alicia Solan-Teglasi”

Alicia Solan-Teglasi

New York, NY

I was standing on a file cabinet in Nov of 2007, drilling new holes to install blinds. I pulled the drill out of the wall and went back catching myself on my right foot. My knee bent in the wrong direction and I heard a pop. I had always been an athlete, so I thought it was just another injury… Read more “James Bosche”

James Bosche

New York, NY

I had an amazing experience with at HSS. Dr Shubin Stein did my TTT (Tibia Tubrical Transfer) on both knees, each 6 months apart, and then screw removal. Both surgeries went way better than I could have imagined. Previously, I had crunching and significant pain especially with stairs. Now I never have pain and feel free to to whatever exercise… Read more “Kimberly Zastenchik”

Kimberly Zastenchik

Mahopac, NY

I have dealt with knee pain for eight years and finally decided to take the necessary measures to live a pain-free life. I came to HSS with hopes of being able to run, Irish-dance, take yoga, and have zero pain in daily activities. I have been active in various team sports throughout the years, but the pain increased when I… Read more “Sarah Perry”

Sarah Perry

Staten Island, NY

I had completely severed my MCL and ACL in a slow motion collision on a ski slope. The surgeons at Vail wanted to operate immediately, but I wanted to return home first. I saw several doctors who told me the MCL would heal first and then I would have to decide whether to go through ACL repair. Each doctor told… Read more “Karen Ganz”

Karen Ganz

Ardsley on Hudson, NY

Imagine your in a sports game. And all of a sudden your knees start hurting. You think it’s just from running and it’ll go away. For a few months it doesn’t go away. You tell your parents and go to a doctor. The first doctor says do physical therapy and you’ll be fine. You do the physical therapy while you… Read more “Taylor Dumond”

Taylor Dumond

Greenville, NY

When I was in 7th grade I dislocated my knee cap for the very first time. It wasn’t until I was in 8th grade when it dislocated again and my parents and I knew something was wrong with my knees. I didn’t go to HSS right away because we didn’t know if it would be that serious. We just went… Read more “Ava Harrison”

Ava Harrison Westfield, NJ

Westfield, NJ

I am 27 years old. A few years ago my knee cap was on the left side of my knee and half of my cartilage was gone on the right side of my knee. So my doctor down here told me he could not do it and he sent me up to HSS see Dr. Shubin Stein. She looked at… Read more “Laura Carhart”

Laura Carhart

Redbank, NJ

My left kneecap started dislocating and subluxating in early adolescence, when I was playing soccer and basketball regularly and also growing tall rather quickly (I wound up close to 5’8). Over the next 15 years, the condition was a constant in my life–I lived with the pain when my kneecap popped out of place a couple of times each year.… Read more “Seyward Darby”

Seyward Darby

Brooklyn, NY

Overview

Shoulder Arthritis is a medical condition where the smooth cartilage covering the ball and socket of the shoulder degenerates over time as a result of wear and tear, injury, or disease.

There are five categories common forms of Shoulder Arthritis:

Osteoarthritis: The degeneration of joint cartilage and the bone beneath it. This condition causes moderate to severe pain and stiffness in affected joints. It is a common condition in middle aged adults.

Inflammatory Arthritis: A group of diseases that feature inflammation of joints and surrounding tissue. The following are commonly grouped under Inflammatory Arthritis:

Rheumatoid Arthritis
Psoriatic Arthritis
Ankylosing Spondylitis
Juvenile Idiopathic Arthritis
Systemic Lupus Erythematosus (lupus)

With these conditions, the joints and their linings are inflamed, causing the cartilage surfaces to wear down. The great news is that modern medicine has progressed significantly in treating the many forms of inflammatory arthritis, rendering surgery a far less common need.

Cuff Tear Arthropathy: A degenerative arthritis that impacts the integrity of rotator cuff tendons over time. It can be characterized as a combination of shoulder arthritis and a large rotator cuff tear. Surgery is recommended to smooth over or completely replace the joint with a prosthesis, and is often the best way to restore functionality.

Osteonecrosis (Avascular necrosis): A rare disease that interrupts the blood supply to the humerus bone that is the ball of the shoulder, causing parts of it to die, and collapse. When the humerus is no longer able to support your arm and shoulder, the cartilage in the shoulder is subject to damaging levels of pressure.

Post-Traumatic Arthritis: A form of osteoarthritis that develops in joints after an injury of any kind. Over time, this condition can lead to the surface of the joint's cartilage to wear out, and disappear entirely.

Common causes for Shoulder Arthritis include:

Wear over time
Injury to shoulder

Common symptoms of Shoulder Arthritis include:

Pain with activity
Stiffness
Limited range of motion

Treatments for Shoulder Arthritis

Non-Surgical Treatment

Before considering surgery, if your injury or condition is not severe, treatment will at first be nonsurgical. Your doctor may recommend the following treatment options, among others:

Increased rest and a decrease in activity levels
Physical therapy sessions at a licensed facility
Over the counter pain medications, including NSAIDs, such as aspirin, which can help with pain and discomfort.
Corticosteroid injections in the shoulder can significantly alleviate inflammation and pain—but only temporarily.
Heat and Ice on the shoulder

Surgical Treatments

Shoulder Arthroscopy - Subacromial Decompression (SAD)

What is the subacromial space? Why does it cause pain?

The subacromial space is located just outside of the shoulder joint capsule, between the acromion of the shoulder blade and the head of the humerus. Structures in the space include the subacromial bursa, coracoacromial ligament, and the supraspinatus tendon. If the rotator cuff of the shoulder is weak, the humeral head will not remain centered in its socket, and will glide upwards during overhead activities, and will pinch the structures in this space. Chronic pinching causes inflammation, resulting in the mechanism known as “Impingement Syndrome”, and is the source of your pain.

What does this surgery entail?

A subacromial decompression is an arthroscopic procedure; the entire procedure is conducted through several small incisions. The damaged tissue crowding the subacromial space is removed and a portion of bone from the underside of the acromion is shaved down to create more space so that the tendons of the rotator cuff are free to glide without impingement or catching on the bone. Essentially, the operation raises the roof of the acromion to allow more space beneath to decrease inflammation. Once adequate space is restored, the supraspinatus tendon will have the opportunity to heal, pain with overhead activities should decrease and range of motion should be restored.

How long will I stay in the hospital?

This surgery is done as ambulatory surgery, meaning you will go home the same day of surgery.

What are the possible risks and complications of surgery?

As with any surgery there is a risk of nerve damage and postoperative infection, though these are extremely rare. Specific risks and complications include but aren’t limited to persistence of symptoms and post-op stiffness.

When can I drive?

You may not drive while taking pain medication or while wearing a sling.

When will I return to my prior level of function?

Typically, a 3-4 month period of rehabilitation is required for full function to return. Working hard in physical therapy, and strictly following the exercise program may shorten this process.

When can I start to run or return to sports?

Running is not recommended for the first 4-8 weeks after surgery. Running does produce stress on the shoulder joint, and will be detrimental to the healing process. You can ride a recumbent bike a couple weeks after surgery and then progress to Elliptical machine without arm motions. Return to sport will be based on your progress with physical therapy and sport of choice. You can expect to return to full strength in 3-4 months. Please see Physical Therapy and Surgical FAQ for more information on this condition.

AC Joint Resection/Distal Clavicle Excision

What is the acromion joint? Why do I have pain here?

The acromion joint connects the end of the clavicle (collar bone) to the acromion of the shoulder blade, the “roof” of the shoulder joint. The acromion joint space is very small and can easily become irritated with inflammation. This inflammation may be caused by repetitive overhead activities or narrowing of the joint space, commonly known as arthritis. Arthritis in this joint occurs in a much younger population than other forms of arthritis. The inflammation in the joint makes the tissue unhealthy and causes pain.

What does this surgery entail?

An AC joint resection, also known as a distal clavicle excision, is an arthroscopic procedure; the entire procedure is conducted though several small incisions. The damaged tissue, and bone, surrounding the acromion joint is shaved down to create more space and to allow the acromion and clavicle to easily glide without creating inflammation. Once adequate space is restored, pain with overhead activities should decrease and range of motion should be restored.

How long will I stay in the hospital?

This surgery is done as ambulatory surgery, meaning you will go home the same day of surgery.

What are the possible risks and complications of surgery?

As with any surgery there is a risk of nerve damage and postoperative infection. Specific risks and complications include but aren’t limited to persistence of symptoms, post-op stiffness, and arthritis.

When can I drive?

You may not drive while taking pain medication or while wearing a sling.

When will I return to my prior level of function?

Typically, a 3-4 month period of rehabilitation is required for full function to return. Working hard in physical therapy, and strictly following the exercise program may shorten this process.

When can I start to run or return to sports?

Total Shoulder Replacement

Am I a candidate for total shoulder (TSR) or reverse total shoulder replacement (rTSR)?

You are a candidate if you have severe shoulder pain, examination findings that point towards arthritis of the shoulder, and if you have tried non-surgical treatments, such as injections and physical therapy, with no relief of symptoms. TSR or rTSR is indicated when there is damage to the cartilage to the glenohumeral joint; the ball (humeral head) and socket (glenoid) joint of the shoulder. Cartilage is the shiny, smooth coating at the end of bones. It protects the bone and allows the bones to move smoothly and efficiently.

What caused my shoulder to become arthritic?

Shoulders can become unstable/arthritic for a variety of reasons. Because they bear significant stress over the course of our life, some degeneration is simply the result of wear and tear on the shoulder, especially the cartilage. This can also be due to certain medical conditions, such as rheumatoid arthritis, trauma, genetics, or a large irreparable rotator cuff tear.

What’s the difference between a TSR and rTSR?

The goal of two surgeries is essentially the same: to replace the arthritic shoulder joint with a new artificial joint. The main difference between the two surgeries is where the two components are placed. The rotator cuff made up of four thick muscles in the shoulder, provides stability to the shoulder, and is in charge of movement of the shoulder. If the rotator cuff is intact, a TSR would be completed, however, if the rotator cuff is torn and not repairable, a rTSR would be completed. In a rTSR, the components are switched. So instead of the ball component going into the humerus and the socket component going into the glenoid (attached to the scapula); the ball component goes into the glenoid, and the socket component goes into the humerus.

What happens during TSR/ rTSR surgery?

During the operation, you will be under general anesthesia, positioned in a “beach-chair,” or sitting up, position. For anesthesia, general and regional anesthesia is used. An incision, 6-8 inches long, is made on the front of the shoulder. The worn ends of the humerus and glenoid are removed and then shaped to fit the implant, which is inserted and attached to the bones with cement. The exact type of implant used is called Biomet Comprehensive Total Shoulder System; it is made of cobalt chrome metal and high molecular weight plastic. Incision is closed with absorbable sutures and Dermabond, surgical glue/tape.

How long will my implants last?

The lifetime of the implants varies, depending on the patient’s lifestyle and compliance with post-operative instructions, the fit of the implants, and, of course, chance. However, 90% of patients have functional implants 10-20 years after their TSR/ rTSR surgery. The reasons for failure include infection, implant instability, or fracture.

How long will I stay in the hospital?

This surgery is an in-patient procedure, meaning you will stay in the hospital after surgery. A typical hospital stay is 1 night. You will then be discharged home.

What are the possible risks and complications of surgery?

As with any surgery there is a risk of DVT, nerve damage, bleeding, and postoperative infection. Specific risks and complications include but aren’t limited to infection, fracture, post-op stiffness, and hardware complications.

When can I drive?

You may not drive while taking pain medication or while wearing a sling.

When can I go back to work?

The recovery time needed before returning to work varies depending on your type of work, but is at least 3 weeks for office work and 8 weeks for manual labor.

When can I start to run or return to sports?

Running does produce stress on the shoulder joint, and will be detrimental to the healing process. You can ride a recumbent bike a couple weeks after surgery and after a few months you can progress to Elliptical machine without arm motions. You should avoid running for the first 3 months. Return to sport will be based on your progress with physical therapy and sport of choice. Typically, a 6 month period of rehabilitation is required for full function to return. Working hard in physical therapy, and strictly following the exercise program may shorten this process.