Purpose
The objective of this 2-part study is to report on the etiology and disease progression
(part I) and results of treatment (part II) of glenohumeral chondrolysis.
Methods
Forty patients presented with glenohumeral chondrolysis after treatment elsewhere.
Twenty patients have been followed since their initial presentation and before prosthetic
shoulder arthroplasty (group 1), and 20 patients were referred either for management
of complications arising after shoulder arthroplasty or for evaluation only (group
2). All patients underwent standardized clinical and radiographic examination and
completed shoulder-specific self-assessment questionnaires at initial presentation
and after prosthetic shoulder arthroplasty for patients in group 1.
Results
Thirty of 40 patients underwent subsequent arthroscopy for debridement, chondroplasty,
capsular release, or a combination of these procedures. Of these, 23 patients (77%)
required additional surgery, comprising 18 prosthetic shoulder arthroplasties performed
at a mean 13 months of follow-up (range, 3 to 33 months), as well as 5 repeated arthroscopies.
At most recent follow-up, 15 of 20 patients in group 1 had undergone shoulder arthroplasty,
with improvements in active forward elevation from 92.6° to 140.0° (P < .0001), active abduction from 81.6° to 131.3° (P < .0001), active external rotation from 22.1° to 49.3° (P < .0001), and active internal rotation from the gluteal region to the T12 spinous
process (P < .001). Pain scores improved from 6.4 to 3.4 (P < .01), and self-assessed outcome also improved significantly. Twelve patients in
group 2 underwent shoulder arthroplasty, so overall 27 of 40 patients (68%) underwent
prosthetic shoulder arthroplasty for chondrolysis at a mean of 32 months (range, 9
to 66 months) after the index procedure.
Conclusions
Postarthroscopic glenohumeral chondrolysis is a devastating condition that strikes
young patients, responds poorly to arthroscopic interventions, and often requires
shoulder arthroplasty within a few years. Patients can expect improved range of motion
and outcome after shoulder arthroplasty, but pain relief is often incomplete.
Level of Evidence
Level IV, therapeutic case series.
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Article Info
Publication History
Accepted:
April 6,
2013
Received:
August 21,
2012
Footnotes
The senior author has received remuneration for expert testimony on behalf of plaintiffs in pain pump litigation that did not relate to physician liability.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
