Treatment of young, active patients with primary glenohumeral osteoarthritis (GHOA) is challenging because shoulder arthroplasty may not be ideal in this population. In the past two decades, joint-preserving arthroscopic management options for GHOA, including débridement, have been used to treat different pathologies related to GHOA to reduce pain, to improve function, and to delay or even avoid arthroplasty. Key aspects of comprehensively addressing GHOA arthroscopically include chondroplasty, synovectomy, loose body removal, humeral osteoplasty with excision of the goat’s beard osteophyte, capsular release, subacromial and subcoracoid decompression, axillary nerve decompression, and biceps tenodesis. Although data are still emerging, clinical studies report that an arthroscopic approach to glenohumeral arthritis using these various procedures reduces pain, improves function, and improves clinical outcome scores in the short- to mid-term follow-up period. Additional high-level studies are warranted to evaluate long-term outcomes and durability following this procedure.
From the Steadman Philippon Research Institiute (Dr. Millett and Dr. Fritz), and the Steadman Clinic, Steadman Philippon Research Institute (Dr. Frangiamore and Dr. Mannava), Vail, CO.
Dr. Millett or an immediate family member has received royalties from Arthrex and MedBridge; serves as a paid consultant to Arthrex; has stock or stock options held in Game Ready and VuMedi; and has received research or institutional support from Arthrex, Össur, Siemens, and Smith & Nephew. Dr. Fritz or an immediate family member has received research or institutional support from Arthrex, Össur, Smith & Nephew, and Vail Valley Medical Center. Dr. Mannava or an immediate family member serves as a board member, owner, officer, or committee member of the Arthroscopy Association of North America. Neither Dr. Frangiamore nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.