It is a degenerative pathological process of the joint surfaces that affects the entire joint (bone, cartilage, joint capsule). It is a very common condition that typically manifests between the ages of 50 and 60, but can also occur at a younger age. It is classified as “primary” osteoarthritis when the cause is unknown, or “secondary” when it occurs due to inflammatory processes, endocrine disorders (diabetes), congenital conditions (dysplasia), or trauma that alters the morphology and functionality of the joint.

In its more severe and complex form, it is caused by a muscle dysfunction of the rotator cuff, which over time leads to wear of the articular cartilage, resulting in pain, loss of strength, and difficulty in movement.

Osteoarthritic pathology is manifested by the wear and gradual resorption of the articular cartilage, reduction of the joint space, abnormal bone production (osteophytes), deformation of the joint surfaces, thickening of the capsule with the formation of calcifications. This results in acute pain and significant limitation in movement. Diagnosis is relatively simple based on symptoms and an X-ray examination.

Therapy is generally planned according to the stage of progression. The most effective treatment is often surgical (shoulder arthroplasty), with the replacement of the affected joint surfaces.

The goal of total shoulder arthroplasty is to reduce pain, recover lost mobility, and improve the patient’s quality of life.

There are two different configurations of shoulder prostheses: “anatomical” and “reverse,” both typically made of 3 components composed of highly biocompatible materials. The reverse configuration is generally indicated for conditions affecting the rotator cuff. The fixation of the prosthesis to the bone can be either without the use of cement (biological fixation) or with cement.

Pharmacological therapies, physical therapy, corticosteroid injections, or other measures can temporarily relieve pain but do not provide a definitive solution.