The so-called shoulder joint actually consists of several joints. All of them are involved in the movement of the shoulder:
The most important is the shoulder joint, which is formed by the head of the humerus and the scapula. Actually, it’s the only joint we’re replacing with an endoprosthesis. The joint between the shoulder joint of the scapula and the clavicle is the shoulder-clavicle joint
Further, closer to the center of the body axis, the other end of the clavicle attaches to the sternum, forming the sternoclavicular joint In addition, the entire scapula slides along the chest wall when the shoulder moves, forming a functional scapular-rib joint, which is not a real joint, because there is no cartilage and a bag, but functionally the surface of the scapula and the chest wall behave like a joint.
The most important shoulder joint is surrounded by a joint bag reinforced with ligaments. The head of the humerus is surrounded by a complex of tendons of the rotator muscles, which are responsible for movement in the joint.
Damage to these tendons (the so-called rotator cuff) is a very common pathology in middle age and older. This is accompanied by irritation of the subbar calcaneus, which provides a slip of the head of the humerus under the shoulder-scapular appendix. We call it subbar tightness syndrome or rotator cuff syndrome. If there is no major damage to the tendons, we try to treat it with the help of rehabilitation, injections into the subbar calcaneus, administration of anti-inflammatory and analgesic drugs.
If, on the other hand, the damage to the tendons is large and accompanied by a restriction of active movement of the shoulder and conservative treatment is not effective, then we consider surgical treatment. It involves the reattachment of damaged tendons to the bone, and sometimes also the modeling of the shoulder-scapular appendix, if its construction is conducive to a conflict with the tendons and the calcaneal spur. This is often done with arthroscopy, a minimally invasive procedure where a camera is inserted into the joint and repairs are made through small incisions.
If, on the other hand, we are dealing with damage to the articular cartilage covering the head of the humerus and the pelvis, then we are talking about a degenerative disease of the shoulder joint. If the damage is large and there is friction of the bone against the bone appear severe pain and limitation of mobility in the joint. This may or may not be accompanied by damage to the rotator cuff tendons.
Such damage we try to treat at first with anti-inflammatory and analgesic drugs. You can try injections into the joint with hyaluronic acid, which improves the properties of synovial fluid. If this treatment is no longer effective, we are left with surgical treatment consisting in implanting an endoprosthesis of the shoulder joint (shoulder joint).