Joint Preservation

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An Overview on Joint Preservation and Cartilage Restoration

Shoulder osteoarthritis is a common condition caused by degeneration of the cartilage that lines the ends of the bones, responsible for providing a pain-free, smooth gliding surface for the bones. Osteoarthritis can occur from natural wear and tear of the joint with aging or from a previous injury that altered the mechanics of the joint. The mechanical changes are often accompanied by  biologic degenerative changes that may not be reversible. Since osteoarthritis cannot be cured, Dr. Matthew Provencher, orthopedic shoulder surgeon, offers patients in the Vail, Aspen and Denver, Colorado communities a number of joint preservation and cartilage restoration techniques designed to return function to the shoulder, while alleviating pain, without shoulder replacement surgery.

Arthritis is a degenerative condition that cannot be reversed or cured, but there are a variety of non-surgical and surgical treatments recommended by Dr. Provencher to decrease the level of joint pain, stiffness and weakness. In mild arthritis cases, Dr. Provencher may prescribe rest, modified activities, anti-inflammatory medications (NSAIDs) and a physical therapy program aimed at strengthening the affected shoulder joint and returning full range of motion.

When shoulder arthritis progresses and non-surgical measures no longer alleviate the symptoms, Dr. Provencher may recommend a surgical intervention. Dr. Provencher offers several joint preservation and cartilage restoration surgical procedures so patients have the ability to prolong or eliminate total shoulder replacement. Dr. Provencher will determine each patient’s ideal surgical treatment based on extent and type of cartilage damage, symptom severity, and the patient’s age.

Patients who experience small lesions with partial fraying or partial loss of cartilage thickness are generally candidates for shoulder arthroscopy, debridement, and chondroplasty. This minimally invasive procedure uses tiny incisions so Dr. Provencher can remove loose pieces of cartilage and stabilize the joint so the lesion or cartilage loss do not become larger over time. This joint preservation and cartilage restoration technique may also require Dr. Provencher to release the capsule and remove the joint lining or any bone spurs if those structures are responsible for joint pain and stiffness.

Patients suffering from full thickness loss of cartilage with good surrounding cartilage may be an ideal candidate for Microfracture. Microfracture  entails Dr. Provencher creating tiny holes in the damaged bone to release marrow. Once the holes are created, marrow will seep out, fill the damaged area, form a blood clot and regrow tissue over the exposed bone. The overall goal of this joint preservation and cartilage restoration technique is to restore and regrow tissue similar to a patient’s lost articular cartilage.

Recovery and Rehabilitation Following Joint Preservation and Cartilage Restoration

A detailed physical therapy program will be prescribed by Dr. Provencher aimed at restoring joint motion and strengthening the surrounding muscles. It is strongly suggested that patients work with the in-house physical therapists at Howard Head Sports Medicine to optimize their rehabilitation. Depending on the joint preservation and cartilage restoration procedure, patients may be encouraged to wear a sling or similar device for several weeks to help immobilize the joint and protect the repair.

For more information on the treatment of shoulder osteoarthritis, or for further resources on joint preservation and cartilage restoration, please contact the office of Dr. Matthew Provencher, orthopedic shoulder surgeon in the Vail, Aspen and Denver, Colorado area.

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