Your shoulder isn’t just one joint, it’s a complex combination of several working together with muscles, tendons and ligaments to give your arms an incredible range of movement, whether you’re combing your hair or playing sport.
Osteoarthritis is the wearing down of the cartilage, the tough, elastic-like tissue that protects the ends of bones where they fit into your joints. If it thins too much, it can cause extra bone to grow – known as osteophytes or bony spurs – which may affect how well your shoulder moves.
It can affect the large ball and socket joint between your upper arm and your body, called the glenohumeral joint, but it’s more common in the smaller joint at the top of your shoulder where your shoulder blade connects to your collarbone – the acromioclavicular or ‘AC’ joint.
Our renowned medical team provides a range of treatments, from the traditional to the innovative:
This is an effective and well-researched procedure that’s a potential alternative to surgery. It takes advantage of the blood’s natural healing properties to reduce pain and improve joint function. It uses a specially concentrated dosage of platelets prepared from your own blood to repair damaged cartilage, tendons, ligaments, muscle and bone. Treatment is administered via an injection and, depending on the injury, two to six injections may be required, performed at weekly intervals. Patients usually see their symptoms improve within four to six weeks of having the injections. PRP is a safe treatment option which, because your own blood is used, carries no risk of allergic reaction. Read more clinical evidence supporting PRP here.
This day case treatment is exclusively offered to our patients. It combines the benefits of Platelet-Rich Plasma (PRP) therapy with Lipogems®, a pioneering procedure that uses your body’s own adipose (fat) cells to treat pain and inflammation. AMPP injections are minimally invasive and are carried out under ultrasound guidance. Altogether the procedure takes about an hour to perform with a minimal recovery time of around three hours. As well as being a potential alternative to surgery, AMPP can also aid post-surgery recovery.
A major one is everyday wear and tear, the normal process of aging. Shoulder osteoarthritis is not just confined to people over 50, many in their 20s and 30s also suffer from it. Other potential causes and factors include your family history, as genetics can influence how it develops, and your medical history, with previous injuries or accidents playing a role that can add up over the years. Other conditions like shoulder dislocations, or any other reasons for unusual shoulder movement that lead to a ‘grinding’ of the joint, can wear down your cartilage more quickly. There is also evidence that certain injections, including local anaesthetic and steroids, can also damage the cartilage. These are best avoided in the glenohumeral joint.
You may have osteoarthritis in your shoulder without any discomfort or reduced movement, but for most people the condition is painful – often at night – with a stiffness that limits your shoulder’s usual wide-ranging mobility. The pain usually comes from your bones rubbing and causing inflammation where the cartilage is worn.
A detailed medical history and a physical examination are very important, but we also use x-rays – and sometimes an MRI scan – to confirm the diagnosis as not all shoulder pain is down to osteoarthritis. Your discomfort might be due to a rotator cuff tear or a problem with your biceps, one of your upper arm muscles. Our experienced consultant will be able identify the exact source of your pain and provide a tailored treatment plan.
Treatment for shoulder arthritis aims to relieve symptoms and improve the function of the joint.
Initial treatment may include medications such as analgesics which help reduce the pain, non-steroidal anti-inflammatory drugs – NSAIDS – which reduce the pain and inflammation. Physiotherapy can help with shoulder arthritis by stretching and strengthening the surrounding muscles.
Osteoarthritis in the acromioclavicular or ‘AC’ joint that causes pain or your shoulder to not move as normal, the options include anti-inflammatory steroid injections which reduce inflammation and provide short-term relief.
We also offer a variety of biological therapies that harness your body’s natural ability to repair itself – Platelet Rich Plasma (PRP) treatment and Activated Mesenchymal Pericyte Plasma (AMPP®) injections.
They are minimally invasive, can decrease inflammation, stop the progression of arthritic damage and may repair joint cartilage. The recovery time is also much shorter than with surgery.
Following these treatments, you are often encouraged to move around the same day and quickly return to normal activity without having to go through the risks associated with surgery.
Osteoarthritis in the acromioclavicular or ‘AC’ joint:
In some cases, an operation to shave away part of the joint, either through keyhole or conventional open surgery, could be an option.
Osteoarthritis in the ball and socket or glenohumeral joint:
Surgery to replace your shoulder or to ‘fuse’ it using screws and plates is possible.
There are some cases where an operation may be your only option. Rather than recommending shoulder replacement or shoulder fusion surgery, we are able to offer a joint preservation technique called Comprehensive Arthroscopic Management (CAM). Mr. Ali Noorani is one of the few specialists that provide this complex keyhole procedure for patients in the UK and Europe via a direct pathway with Orthopaedic Specialists.
Complex cases are often referred to us from across the UK and abroad to benefit from our experience and expertise. For all our patients, we provide a tailor-made treatment plan, which may include a combination of surgical and non-surgical options, along with rehabilitation.
Our innovative range of treatments goes beyond what’s available on the NHS. As well as providing a full opinion on your condition, our experienced consultants will also assess your suitability for our alternative biological therapies, Platelet Rich Plasma (PRP) and Activated Mesenchymal Pericyte Plasma (AMPP).
– discuss your medical history to find out more about your symptoms
– carry out a clinical examination to look at the joint and identify the source of the pain and mobility issues
– arrange for a diagnostic investigation, for example using an X-ray and/or MRI scan to assess the issue
– discuss all the treatment options with you, along with their potential benefits and any risks.
Our experienced team works as part of a collaborative partnership of surgeons, sports medicine doctors and physiotherapists to provide the perfect patient pathway to get you quickly on the road to recovery. Whether you need conventional treatment or if you are a candidate for our regenerative treatments, you can be sure that you will get the best advice.
Autologous means ‘from the same person’ rather than from a donor. Essentially, your own cells are used to encourage healing. With this type of treatment, there’s a dramatic reduction in the risks of the rejection, infection or contamination that come with using material from someone else. The innovative therapies we offer are based on this idea. If you’ve found traditional treatments aren’t helping your pain, or if you’re looking for a possible alternative to surgery, then this approach is one to consider.
Biological treatments are pioneering procedures and we’re continuously monitoring and recording its effectiveness. Patients undertaking these treatments are asked to complete pre-operative and post-operative questionnaires.
The information obtained from these questionnaires allows us to monitor your progress and it also contributes to our evidence-based database and other global studies on biological treatments. All information gathered is anonymised.