"Arthritis in the Knee and Shoulder: An Overview" FAQs

Public and Patient Education Department Program, May 4, 2004


Struan H. Coleman, MD, PhD

Struan H. Coleman, MD, PhD

Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Attending Orthopaedic Surgeon, NewYork-Presbyterian Hospital
Associate Professor of Clinical Orthopaedic Surgery, Weill Cornell Medical College

What causes knee and shoulder arthritis?

Three basic types of arthritis may affect the shoulder and knee joints:

Knee Arthritis:

  • Osteoarthritis (OA) is the most common form of knee arthritis. OA is usually a slowly progressive degenerative disease in which the joint cartilage gradually wears away. It most often affects middle-aged and older people.
  • Rheumatoid arthritis (RA) is an inflammatory type of arthritis that can destroy the joint cartilage. RA can occur at any age. RA generally affects both knees.
  • Post-traumatic arthritis can develop after an injury to the knee. This type of arthritis is similar to osteoarthritis and may develop years after a fracture, ligament injury, or meniscus tear.

Shoulder Arthritis:

  • Osteoarthritis, or "wear-and-tear" arthritis, is a degenerative condition that destroys the smooth outer covering (articular cartilage) of bone. It usually affects people over 50 years of age and is more common in the AC joint than in the glenohumeral shoulder joint.
  • Rheumatoid arthritis is a systemic inflammatory condition of the joint lining. It can affect people of any age and usually affects multiple joints on both sides of the body.
  • Post-traumatic arthritis is a form of osteoarthritis that develops after an injury such as a fracture or dislocation of the shoulder. Arthritis can also develop after a rotator cuff tear.


Can a torn ligament heal itself through physical therapy?

A rehabilitation plan is needed if you have a cruciate or collateral ligament injury. Most rehabilitation plans include:

  • Passive range-of-motion exercises designed to restore flexibility.
  • Braces to control joint movement.
  • Exercises to strengthen the quadriceps muscles in the front of the thigh. (Muscle strength is necessary to provide the knee joint with as much support and stability as possible when weight is placed on it.)
  • Additional exercises on a high-seat exercise bicycle followed by more strenuous quadriceps exercise.

Your progress and the ability of your knee to function as a normal knee will determine how long you must use crutches and a brace.


Are steroid injections a good treatment for knee and shoulder arthritis?

Non-surgical treatment includes the use of NSAIDs (non-steroidal anti-inflammatory drugs) - such as ibuprofen and naprosyn as well as a newer class of agents called the Cox-2 inhibitors - for reduction of inflammation and pain relief. Injection with steroids can offer temporary, symptomatic relief, but are not generally recommended for prolonged use. Visco-supplementation involves injection of a viscous substance that resembles the synovial fluid normally found in the joints. This therapy also offers temporary relief of symptoms in some patients, but repeated injections are required. Some patients also report relief of symptoms after taking glucosamine and chondroitin supplements; however, there is not a good body of scientific evidence to establish their efficacy, and the FDA does not regulate their use.

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