The role of arthroscopic debridement in the treatment of severe glenohumeral osteoarthritis (OA) has not been clearly defined. Our hypothesis is that arthroscopic debridement is a viable option in the treatment of severe glenohumeral OA.
A retrospective review was undertaken of twenty-one patients who underwent arthroscopic glenohumeral debridement for severe OA between 1996 and 2005 at our center. The operative procedure included intra-articular lavage, debridement of osteophytes, removal of loose bodies, capsular release, and synovectomy. Our technique utilized an accessory posterior-inferior portal in order to excise as much of the characteristic inferior humeral osteophyte as possible. The goals of removing the “goat’s beard” osteophyte were the restoration of motion (particularly rotation through improved mechanics), and pain relief (via increased diffusion of load forces). Twelve patients were successfully contacted postoperatively, and completed questionnaires which focused on pre-and post-operative pain and activity restriction, as well as overall satisfaction. The twelve patients had a mean age of 59.1 years (range 44-67) at time of surgery, and were contacted at a mean of 51.9 months (range 8-114) after surgery. Statistical analyses were performed using the paired t-test.
Nine out of twelve patients responded that they would undergo the same procedure again given the same situation. Six were extremely satisfied with their result, three were somewhat satisfied, and three were dissatisfied. Subjective pain assessed using the VAS rating from 0-10 points decreased significantly from a mean of 6.2 pre-operatively to 3.2 post-operatively (p=0.01). Subjective assessment of shoulder function using the scale incorporated in the Constant score significantly increased from a mean of 1 pre-operatively to 4.3 post-operatively(p=0.002). Two thirds of our sample (eight out of twelve patients) returned to regular participation in sports or physically demanding recreational activity. Results did not deteriorate with time.
Arthroscopic glenohumeral debridement for severe OA led to substantial improvement in patient satisfaction, pain, and function, in eight out of twelve patients. Studies with a prospective design, incorporation of objective outcome measures, and comparison to other surgical options for severe glenohumeral OA would further elucidate the role of arthroscopic debridement.
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.