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With minor trauma, nodules are shed as small bodies into the joint space. In some patients, the disease process may involve tendon sheaths and bursal sacs. Cartilaginous intra-articular bodies float freely within the synovial fluid, which they require for nutrition and growth. Progressive enlargement and ossification occur with time.
Surgery may be done arthroscopically or as open surgery. The impinging structures may be removed in surgery, and the subacromial space may be widened by resection of the distal clavicle and excision of osteophytes on the under-surface of the acromioclavicular joint. [4] Damaged rotator cuff muscles can be surgically repaired.
Joint space narrowing, with or without subchondral sclerosis. Joint space narrowing is defined by this system as a joint space less than 3 mm, or less than half of the space in the other compartment, or less than half of the space of the homologous compartment of the other knee. II: Obliteration of the joint space III: Bone defect/loss < 5 mm IV
The surgery can be performed through an open or arthroscopic procedure. A regimen of physical therapy following surgery is prescribed and most patients experience full recovery within 8 to 10 weeks post-surgery. [1] The procedure was created by, and named for, orthopedic surgeon Eugene Bishop Mumford in 1941. [2] [3]
The joint space equals the distance between the involved bones of the joint. A joint space narrowing is a sign of either (or both) osteoarthritis and inflammatory degeneration. [12] The normal joint space is at least 2 mm in the hip (at the superior acetabulum), [13] at least 3 mm in the knee, [14] and 4–5 mm in the shoulder joint. [15]
Recently, there has been a published case report of decrease in knee pain in a single individual using autologous mesenchymal stem cells. An advantage to this approach is that a person's own stem cells are used, avoiding transmission of genetic diseases. It is also minimally invasive, minimally painful and has a very short recovery period.
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