Shoulder Arthroscopy for Degenerative Joint Disease
Introduction
Degenerative disease of the glenohumeral joint is a significant problem primarily affecting older patients. However, in some cases it can also impact younger, active individuals. As shown by Matsen et al., these patients have significant pain and are functionally limited when compared with patients with normal shoulders. Gartsman et al. further illustrated a significant decrease in Short Form 36 variables with shoulder arthrosis. Thus, shoulder arthrosis creates a substantial patient burden.
Multiple sources can contribute to patient discomfort in addition to the joint degeneration, including labral pathology, biceps tenosynovitis, rotator cuff pathology, loose bodies, and articular cartilage damage. Initial treatment for these conditions consists of conservative management with physical therapy, injections, and activity modification. However, if these measures fail and the patient continues to have significant pain, the surgeon is left with relatively few options. Shoulder arthroplasty has been shown to provide good pain relief but has significant risks and results in postoperative limitations. In the younger and more active patient population, these post-replacement restrictions may impair lifestyle or job requirements. Furthermore, there is a heightened concern about prosthetic loosening and early failure in this patient population.
In lieu of arthroplasty, arthroscopy of the shoulder may provide improvements in symptoms and increases in shoulder function as well as prevent or delay the need for shoulder arthroplasty. Multiple arthroscopic techniques can be used, including debridement, chondroplasty, capsular release, biceps tenotomy or tenodesis, and subacromial decompression, in an attempt to improve symptoms and shoulder function. Limited reports to date have provided evidence that arthroscopic techniques may improve shoulder pain and function for patients with shoulder arthritis.
The purpose of this study was to review the outcomes of patients who have undergone arthroscopic debridement procedures for glenohumeral degenerative joint disease at a single institution. The hypothesis was that arthroscopic management of shoulder arthritis would result in improvement in shoulder pain and function.
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