Symptoms

The symptoms of cartilage damage to the shoulder are very similar to other shoulder injuries. These include:

Pain, which is often accompanied by “overhead” work, a “cracking” in the joint, with or without associated pain
Pain in the night
A feeling of instability of the shoulder joint
Restrictions of movement in the joint
Starch losses
Swellings and
Other signs of inflammation such as warming and redness

Diagnosis

The experts for injuries to the joints, and therefore also for diseases that are associated with cartilage damage in the shoulder joint, are specialists in orthopedics or general medicine. In order to make a diagnosis, it is important to know whether the pain is directly related to an accident, how long it has been present and which movements cause pain. In order to find this out, the attending physician will perform a number of tests to examine stability and freedom of movement, among other things.

To rule out other problems, X-rays can be taken, but cartilage tissue cannot be examined in them. To be able to assess this, an MRI of the shoulder joint (magnetic resonance topography) is therefore usually ordered. In this case, a contrast medium may be injected to better assess the damage.

In most cases, however, the final diagnosis can only be made during arthroscopy. The International Cartilage Repair Society has established different degrees of severity for the classification of cartilage damage: Grade 0: (normally) healthy cartilage tissue Grade 1: The cartilage has soft spots or blisters Grade 2: Small damages to the cartilage are visible Grade 3: Damages with gap formation (if more than 50% of the cartilage tissue in the joint is damaged) Grade 4: The damages to the cartilage extend to the underlying bone and expose it. The cartilage damage in the shoulder joint can best be assessed by MRI.

Therapy

There are two concretely different therapeutic approaches for cartilage damage in the shoulder joint. One is conservative therapy, to which many patients respond well, depending on the size and type of cartilage damage. This therapy includes the use of pain and anti-inflammatory drugs (NSAIDs), and exercises for the joint with physiotherapy or at home.In addition, conservative therapy is recommended to alleviate the symptoms and expose the joint to as little stress as possible.

If the damage is not excessive, it is quite possible that this treatment will meet all the patient’s needs. However, if this conservative method proves to be inadequate, the treating physician may consider surgery. Most cartilage damage to the shoulder joint is treated by arthroscopy.

This is a minimally invasive operation that uses various methods to restore cartilage tissue. In most cases a technique called microfracturing is used. This is intended to produce bleeding that stimulates the tissue to form cartilage. The procedure of cartilage transplantation, in which cartilage is taken from other joints and inserted into the affected joint, has not yet become established in the treatment of cartilage damage in the shoulder joint.