Nathan W Skelley1, Surena Namdari2, Aaron M Chamberlain2, Jay D Keener2, Leesa M Galatz2, Ken Yamaguchi2. 1. Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri, U.S.A.. Electronic address: skelleyn@wudosis.wustl.edu. 2. Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri, U.S.A.
Abstract
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.
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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