Videoarthroscopic treatment of glenohumeral osteoarthritis

Objetive: To evaluate possible benefits obtained through the use of surgical videoarthroscopy in the management of glenohumeral osteoarthritis. Methods: We evaluated 37 patients (38 shoulders) who underwent through surgical videoarthroscopy in the period between November 1999 and May 2009 (minimum follow-up of two years). Twenty five patients attend for revaluation and thirteen were interviewed by telephonic contact. Functional assessments were performed (UCLA, Constant, and measurement of range of motion –ROM-), as well as pre and post surgical radiographics. We evaluated the influence of the following factors in the final results: the presence of chondral lesions, joint space narrowing, osteophyte presence, associated injuries (rotator cuff torn or instability), and follow-up. Among those patients interviewed by phone we evaluated the satisfaction level and if they would submit themselves again to the surgical procedure. Results: It was observed significant gain towards to the function (UCLA) and the internal rotation, as well as the association between dissatisfaction and pre surgical joint space reduced. Among the operated patients, 84% were satisfied with the results and 86.6% would repeat the procedure. Conclusion: Surgical videoarthroscopy presents a relevant role in management of the glenohumeral osteoarthritis, providing improvement of functional results and high levels of satisfaction. © 2013 Sociedade Brasileira de Ortopedia e Traumatologia. Published by Elsevier Editora Ltda. All rights reserved 70 Rev Bras Ortop. 2013;48(1):69-79 Fig. 1 Samilson and Prieto classification:12 A) Mild arthrosis – lower osteophyte of the humeral head and/or glenoid smaller than 3 mm; B) Moderate arthrosis – lower osteophyte of the humeral head and/or glenoid measuring 3 to 7 mm, with gentle irregularity of the joint surface; C) Advanced arthrosis – lower osteophyte of the humeral head and/or glenoid larger than 7 mm, reduction of the joint space and bone sclerosis. Introduction Osteoarthritis of the glenohumeral joint is not uncommon and may affect more than 20% of the elderly population. Its therapeutic management begins with conservative methods, with the aims of alleviating painful symptoms and improving range of motion. Lifestyle changes, analgesic and anti-inflammatory medication, physiotherapy, joint infiltrations with corticoids and viscosupplementation have been mentioned in the literature.1-5 When conservative methods fail, total arthroplasty or hemiarthroplasty provide significant relief of painful symptoms and functional improvement, particularly in more elderly populations (over the age of 60 years). However, in younger populations (under the age of 50 years) that are active, these procedures do not present the same results, due mainly to the high functional demands made by this age group, their functional expectations and the length of survival of the implants, especially the glenoid component.1,4,6,7 Among patients with this profile, arthroscopic management may provide relief for painful symptoms and functional improvements. However, it is incapable of restoring joint cartilage that presents lesions.8,9 The arthroscopic procedures of lavage and debridement provide satisfactory short-term results for 70 to 88% of these patients.8-10 The aim of the present study was to evaluate the results from videoarthroscopic treatment among patients with glenohumeral osteoarthritis.