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Arthroscopic Treatment Options for Glenohumeral Osteoarthritis

  • Werner AnderlEmail author
  • Brenda Laky
  • Philipp R. Heuberer
Chapter

Abstract

Osteoarthritis (OA) of the shoulder is a chronic, progressive, and multifactorial disease characterized by degenerative and inflammatory processes affecting the glenohumeral joint. The incidence of primary OA has been reported as approximately 5 % of patients with shoulder complaints. Although OA in the shoulder is less common than OA of the knee or hip, OA can cause severe pain and dysfunction of the shoulder. Pathologic changes in shoulder OA involve the progressive breakdown of the articular cartilage within the glenohumeral joint starting with narrowing of the joint space and fibrillation of the surface, followed by osteochondral lesions, osteophyte formations, labrum degradation, capsular tightness, and inflammation. As OA may also affect supporting structures such as muscles, tendons, and ligaments, shoulder joint degeneration can also be linked to secondary causes such as rotator cuff tendon tears, shoulder instability especially in young patients, and trauma.

Keywords

Humeral Head Cartilage Defect Autologous Chondrocyte Implantation Glenohumeral Joint Axillary Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 43.1

After capsular release, osteophytes are dissected and removed with a burr and/or a curved chisel, while the axillary nerve and accompany vessels remain protected by a Wissinger rod (MPG 11182 kb)

References

  1. 1.
    Gartsman GM, Taverna E. The incidence of glenohumeral joint abnormalities associated with full-thickness, reparable rotator cuff tears. Arthroscopy. 1997;13:450–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Laudicina L, D’Ambrosia R. Management of irreparable rotator cuff tears and glenohumeral arthritis. Orthopedics. 2005;28:382–8.PubMedGoogle Scholar
  3. 3.
    McCarty DJ, Halverson PB, Carrera GF, Brewer BJ, Kozin F. “Milwaukee shoulder”-association of microspheroids containing hydroxyapatite crystals, active collagenase, and neutral protease with rotator cuff defects. I. Clinical aspects. Arthritis Rheum. 1981;24:464–73.PubMedCrossRefGoogle Scholar
  4. 4.
    Brophy RH, Marx RG. Osteoarthritis following shoulder instability. Clin Sports Med. 2005;24:47–56.PubMedCrossRefGoogle Scholar
  5. 5.
    Hovelius L, Augustini BG, Fredin H, Johansson O, Norlin R, Thorling J. Primary anterior dislocation of the shoulder in young patients. A ten-year prospective study. J Bone Joint Surg Am. 1996;78A:1677–84.Google Scholar
  6. 6.
    Taylor DC, Arciero RA. Pathologic changes associated with shoulder dislocations. Arthroscopic and physical examination findings in first-time, traumatic anterior dislocations. Am J Sports Med. 1997;25:306–11.PubMedCrossRefGoogle Scholar
  7. 7.
    Ogilvie-Harris DJ, Wiley AM. Arthroscopic surgery of the shoulder. A general appraisal. J Bone Joint Surg Br. 1986;68B:201–7.Google Scholar
  8. 8.
    Weinstein DM, Bucchieri JS, Pollock RG, Flatow EL, Bigliani LU. Arthroscopic debridement of the shoulder for osteoarthritis. Arthroscopy. 2000;16:471–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Kerr BJ, McCarty EC. Outcome of arthroscopic debridement is worse for patients with glenohumeral arthritis of both sides of the joint. Clin Orthop Relat Res. 2008;466:634–8.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Cameron BD, Galatz LM, Ramsey ML, Williams GR, Iannotti JP. Non-prosthetic management of grade IV osteochondral lesions of the glenohumeral joint. J Shoulder Elbow Surg. 2002;11:25–32.PubMedCrossRefGoogle Scholar
  11. 11.
    Richards DP, Burkhart SS. Arthroscopic debridement and capsular release for glenohumeral osteoarthritis. Arthroscopy. 2007;23: 1019–22.PubMedCrossRefGoogle Scholar
  12. 12.
    Van Thiel GS, Sheehan S, Frank RM, Slabaugh M, Cole BJ, Nicholson GP, et al. Retrospective analysis of arthroscopic management of glenohumeral degenerative disease. Arthroscopy. 2010;26:1451–5.PubMedCrossRefGoogle Scholar
  13. 13.
    Millett PJ, Gaskill TR. Arthroscopic management of glenohumeral arthrosis: humeral osteoplasty, capsular release, and arthroscopic axillary nerve release as a joint-preserving approach. Arthroscopy. 2011;27:1296–303.PubMedCrossRefGoogle Scholar
  14. 14.
    Steadman JR, Rodkey WG, Rodrigo JJ. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001;391:S362–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Siebold R, Lichtenberg S, Habermeyer P. Combination of microfracture and periostal-flap for the treatment of focal full thickness articular cartilage lesions of the shoulder: a prospective study. Knee Surg Sports Traumatol Arthrosc. 2003;11:183–9.PubMedGoogle Scholar
  16. 16.
    Millett PJ, Huffard BH, Horan MP, Hawkins RJ, Steadman JR. Outcomes of full-thickness articular cartilage injuries of the shoulder treated with microfracture. Arthroscopy. 2009;25:856–63.PubMedCrossRefGoogle Scholar
  17. 17.
    Frank RM, Van Thiel GS, Slabaugh MA, Romeo AA, Cole BJ, Verma NN. Clinical outcomes after microfracture of the glenohumeral joint. Am J Sports Med. 2010;38:772–81.PubMedCrossRefGoogle Scholar
  18. 18.
    Romeo AA, Cole BJ, Mazzocca AD, Fox JA, Freeman KB, Joy E. Autologous chondrocyte repair of an articular defect in the humeral head. Arthroscopy. 2002;18:925–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Scheibel M, Bartl C, Magosch P, Lichtenberg S, Habermeyer P. Osteochondral autologous transplantation for the treatment of full-thickness articular cartilage defects of the shoulder. J Bone Joint Surg Br. 2004;86B:991–7.CrossRefGoogle Scholar
  20. 20.
    Siebold R, Sartory N, Yang Y, Feil S, Paessler HH. Prone position for minimal invasive or all-arthroscopic autologous chondrocyte implantation at the patella. Knee Surg Sports Traumatol Arthrosc. 2011;19:2036–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Ebert JR, Fallon M, Ackland TR, Wood DJ, Janes GC. Arthroscopic matrix-induced autologous chondrocyte implantation: 2-year outcomes. Arthroscopy. 2012;28:952-64e1-2.Google Scholar
  22. 22.
    Savoie 3rd FH, Brislin KJ, Argo D. Arthroscopic glenoid resurfacing as a surgical treatment for glenohumeral arthritis in the young patient: midterm results. Arthroscopy. 2009;25:864–71.PubMedCrossRefGoogle Scholar
  23. 23.
    de Beer JF, Bhatia DN, van Rooyen KS, Du Toit DF. Arthroscopic debridement and biological resurfacing of the glenoid in glenohumeral arthritis. Knee Surg Sports Traumatol Arthrosc. 2010;18:1767–73.PubMedCrossRefGoogle Scholar
  24. 24.
    Gobezie R, Lenarz CJ, Wanner JP, Streit JJ. All-arthroscopic biologic total shoulder resurfacing. Arthroscopy. 2011;27:1588–93.PubMedCrossRefGoogle Scholar
  25. 25.
    Uribe JW, Botto-van BA. Partial humeral head resurfacing for osteonecrosis. J Shoulder Elbow Surg. 2009;18:711–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Matsen 3rd FA, Clinton J, Lynch J, Bertelsen A, Richardson ML. Glenoid component failure in total shoulder arthroplasty. J Bone Joint Surg Am. 2008;90A:885–96.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Werner Anderl
    • 1
    Email author
  • Brenda Laky
    • 1
  • Philipp R. Heuberer
    • 1
  1. 1.Department of Orthopedic SurgerySt.Vincent HospitalViennaAustria

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