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I injured my spinal cord in a car accident 10 years ago. I use my arms to propel a wheelchair. This is causing some shoulder pain and early arthritis. If it gets bad enough, can I have joint replacements?

A team of experts, including you, must make this decision. A physical therapist will test muscle strength. A doctor will assess the size, shape, and condition of the joint. The condition of the muscles and tendons is also reviewed.

Your general health, smoking and drinking habits, and overall nutrition will be part of the deciding factors. Slow or poor wound healing can occur from poor health, diet, and lifestyle choices.There is a greater risk of implant loosening in patients who rely heavily on the arms to operate a wheelchair.

A rehab program now is ideal. A physical therapist can help you increase and keep muscle strength in the arms. This will protect the joints. The use of a small-motorized scooter may be a good idea to save wear and tear on the joints.

Reference: 

Joseph Mileti, MD, et al. Shoulder Arthroplasty For the Treatment of Postinfectious Glenohumeral Arthritis. In The Journal of Bone and Joint Surgery. April 2003. Vol. 85-A. No. 4. Pp. 609-614.

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