Purpose
The purpose of this study was to evaluate patients who underwent isolated arthroscopic
debridement and capsular release without any other procedures for primary glenohumeral
osteoarthritis to determine clinical and functional outcomes and time until conversion
to shoulder arthroplasty.
Methods
We performed a retrospective review of 33 patients who underwent arthroscopic debridement
and capsular release for shoulder osteoarthritis at our institution between 2006 and
2011. All procedures were performed by a single surgeon (K.Y.). Patients were evaluated
for intraoperative arthritis grade, preoperative and postoperative range or motion,
American Shoulder and Elbow Surgeons (ASES) score, pain score self-assessments, radiographic
evaluation, and conversion to total shoulder arthroplasty. Clinical follow-up was
on average 40.3 weeks postoperatively and telephone interview follow-up was performed
at a minimum of 2 years postoperatively in all patients.
Results
There was an initial improvement in range of motion and pain scores; however, patients
in our study returned to preoperative levels approximately 3.8 months after debridement
and capsular release. Twenty patients (60.6%) reported that they were not satisfied
with the outcome of the procedure. Total shoulder arthroplasty was undertaken in 14
(42.4%) patients an average of 8.8 months after arthroscopy. Among the 19 (57.6%)
patients who did not go on to have total shoulder arthroplasty, ASES scores (42.2
to 50.8; P = .41) and visual analog scale pain scores (7.8 to 7.4; P = .59) were similar preoperatively and at final telephone follow-up.
Conclusions
Isolated arthroscopic debridement and capsular release without any other procedures
were associated with only temporary pain relief and improvement in motion. Although
there are limited nonarthroplasty surgical options available for glenohumeral arthritis,
isolated arthroscopic debridement and capsular release may not provide substantial
benefit to justify its use in most patients.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: November 08, 2014
Accepted:
August 26,
2014
Received:
January 28,
2014
Footnotes
The authors report the following potential conflict of interest or source of funding: K.Y. receives support from Zimmer and Tornier.
Identification
Copyright
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
