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Arthroscopic debridement and capsular release for glenohumeral osteoarthritis (SS-21)

      Purpose: The purpose of this study was to determine the efficacy of arthroscopic debridement and capsular release in the treatment of glenohumeral osteoarthritis. Methods: Patients that had been diagnosed with glenohumeral osteoarthritis and had a subsequent arthroscopic debridement and capsular release were assessed using American Shoulder and Elbow Surgeons (AS&E), Constant, Rowe, UCLA, and Walch- Duplay. Preoperative radiographs and arthroscopic findings were assessed and patients were classified into one of four osteoarthritis groups. Each osteoarthritic group was compared statistically, as well as the patient’s pre- and postoperative range of motion. Statistical analysis of our data was done using a Student t test. Results: The average follow-up for the eight patients (9 shoulders) was 13.7 ± 4.9 months. This study demonstrated that arthroscopic debridement and capsular release provided relief of pain for 9.3 ± 4.6 months. The average range of forward elevation preoperative was 131.9 ± 47.6 ° and improved to 153.3 ± 34.6° postoperatively. The average external rotation prior to surgery was 42.8 ± 23.3° and increased to 59.4 ± 23.0° after surgery. Internal rotation improved after surgical intervention from 17.2 ± 5.7° to 48.3 ± 22.2°. Four patients were classified as having moderate osteoarthritis and four patients (5 shoulders) were determined to have severe osteoarthritic changes. A statistical analysis using a Student t test demonstrated that the AS&E score, the Walch-Duplay score, and the UCLA score were significantly better in those patients with moderate glenohumeral osteoarthritis compared to those patients with severe osteoarthritis. Conclusions: Arthroscopic debridement and capsular release provided relief of pain for an average of over nine months even in cases of severe osteoarthritis. Patients with moderate osteoarthritis had a good functional outcome after surgery and their results were superior to those with severe degenerative changes. Based upon these results, arthroscopic debridement and capsular release appears to be beneficial in the treatment of mild and moderate glenohumeral osteoarthritis.