Prevalence of shoulder disorders in tertiary care centre.

Background: Shoulder pain is the third most common musculoskeletal condition has a lifetime prevalence of up to 70% and this seems to be increasing in incidence. The diagnosis of these disorders is based primarily upon results of clinical tests. The prevalence of shoulder pain in India has not been reported. The aim of present study is to study and report the prevalence of various disorders causing shoulder pain in patients reporting to a tertiary care hospital in North India. Methods: This is a prospective hospital based cross-sectional study carried in a tertiary care hospital and 130 patients satisfying inclusion criteria over a period of two year were included. Results: Age of patients ranged between 23-69 years (51.36 ± 11.86 years). A predominance of females was observed (Male-Female ratio: 0.81:1). The commonest cause of pain was periarthritis shoulder (43.1%), subacromial (SA) impingement (13.8%), acute rotator cuff injury (13.1%), GH arthritis (10.0%) and AC Arthritis (8.5%). The major risk factors were diabetes mellitus, excessive overhead lifting and trauma. Conclusion: Periarthritis and subacromial pain syndrome are two most common diagnoses reporting to a tertiary care centre. Periarthritis is the commonest diagnosis in both genders. AC arthritis is more common in females (P <0.001) and rotator cuff injury is more in males (P <0.001). Periarthritis, GH arthritis and AC arthritis is much more common in fifth and sixth decades and rotator cuff injury is seen in young adults.

Rotator Cuff Deficient Arthritis of the Glenohumeral Joint

Rotator cuff deficient arthritis of the glenohumeral joint, especially cuff tear arthropathy, has proved a challenging clinical entity for orthopaedic surgeons ever since Charles Neer originally detailed the problem in 1983. Understanding has improved regarding the pathophysiology and pathomechanics underlying cuff tear arthropathy. Surgical reconstruction options can lead to excellent outcomes for patients afflicted with these painful and functionally limited shoulders. Humeral hemiarthroplasty and reverse total shoulder arthroplasty have jumped to the forefront in the treatment of cuff tear arthropathy. As studies continue to look at the results of these procedures in cuff tear arthropathy, existing indications and treatment algorithms will be further refined. In this article the history and pathophysiology of cuff tear arthropathy are reviewed. Additionally, the clinical findings and results of surgical reconstruction are discussed.

Shoulder Operation

Although shoulder pain is a very common problem and compromised shoulder movement due to pain, stiffness, or weakness can cause substantial disability, many patients fail to recognize a need for a proper treatment. The diagnosis and treatment of the shoulder should be specified for each of the disease entity. Most of shoulder pain can be managed non-operatively with a well-organized rehabilitation program. However, the surgery should always remain as an option in case of failure of conservative managements, which can be seen from a definite indication of a patient's condition. The article presents four representative disease entities other than shoulder trauma occurring in old age which doctors see most often at outpatient's clinics. Impingement syndrome, rotator cuff tear, calcifying tendonitis, and arthritis are described in this article, introducing each diseases and surgical indications and descriptions, and their results.