Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I have painful shoulder osteoarthritis. My shoulder is constantly dislocating. Should I have a joint replacement?

Answer:

Severely painful and limiting shoulder motion and function are the usual reasons why patients end up having a shoulder replacement.It is best to have an orthopedic surgeon evaluate you and find out exactly what's going on and what you may benefit from in the way of conservative care before having a total shoulder replacement. The usual first line-of-treatment for the kind of instability you are describing is with antiinflammatories and physical therapy. A program of strengthening and flexibility exercises can be very helpful and can even help some patients delay or avoid surgery altogether. Sometimes what people with shoulder osteoarthritis feel is a shoulder dislocation is really what we call crepitus. Crepitus is the crunching, crackling, clicking, or clunking noises and feelings people experience when bone spurs or uneven joint surfaces rub against each other or get stuck. It may seem like a dislocation but isn't always. After evaluating your shoulder motion and performing special tests to identify the problem (or level of instability), your surgeon will be able to tell you if the shoulder is unstable and dislocating or if your feeling of dislocation is crepitus. X-rays may be ordered (if that hasn't already been done) to look for signs of arthritic changes at the joint surfaces and narrowed joint space. An MRI or other advanced imaging studies may be used to look for soft tissue damage. Once your surgeon has all of the information available, a decision can be made as to the best treatment approach for you. That may end up being a joint replacement but likely conservative (nonoperative) care will be recommended first. There is help for your problem. Don't delay in seeking medical services. Often early intervention can keep problems like this from getting far worse. R. Frank Henn III, MD, et al. Preoperative Patient Expectations of Total Shoulder Arthroplasty. In The Journal of Bone and Joint Surgery. November 16, 2011. Vol. 93-A. No. 22. Pp. 2110-2115.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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