I saw a patient in the office recently whose x-rays were a testament to two important points about shoulder arthritis:
For a given patient, shoulder arthritis in the ball and socket portion of the joint usually occurs in both arms.
We don’t totally understand why this is. There is likely some genetic predisposition that we have yet to fully figure out. But it’s true: if you’ve got shoulder arthritis in one arm, you will often have it in both.
The shoulder with the worse looking x-ray isn’t always the most painful shoulder.
The x-rays below were done for the same patient, at the same time, but on two different arms. This is a 70 year old man who has arthritis in both shoulders. The left x-ray has less severe arthritis: less bone spur, less wear of the socket.
But the left shoulder bothers him more. This is a point that we see rearing its head often: your x-rays and MRIs do not tell the whole story. Pain, like we humans, is complicated and you can’t always tell which arm is going to hurt more.
This gentleman has had pain now for 15 years. He has had knee replacements for arthritis and is now requesting shoulder replacement surgery. In this case he would like his left one done first.
If someone wants both shoulders replaced we will typically allow at least a few months between operations so that you will have at least one fully functioning arm to help with daily activities.