ICL 207 Glenhumeral Arthritis in the Young Patient: Arthroscopic and Other Options-Curtis Handout

Curtis Handout

Pdf Summary

This document addresses gleno-humeral arthritis in young patients, discussing its causes, presentation, and treatment options, particularly arthroscopic and other modalities. Causes include genetic factors, inflammatory diseases (rheumatoid arthritis, lupus, Lyme disease, gout), trauma (contact sports, instability, motor vehicle accidents), and surgical complications such as labral, SLAP, and rotator cuff repairs or chondrolysis.<br /><br />Patients often present with vague pain worsened by activity, gradual loss of range of motion, difficulty with overhead sports, stiffness, crepitus, and common night pain, sometimes postoperatively.<br /><br />Treatment begins conservatively with NSAIDs, rest, activity modification, physical therapy focused on restoring motion, posture, and strengthening the rotator cuff, and occasionally intra-articular corticosteroid injections (guided by ultrasound or fluoroscopy). Non-operative management aims to control symptoms and maintain function.<br /><br />Operative treatment primarily involves arthroscopic debridement with a “less is better” philosophy to minimize soft tissue trauma and bleeding, promoting better motion and reduced pain. Surgical goals include releasing adhesions, smoothing joint surfaces, contouring the labrum, debriding cuff or biceps tissue, and bursectomy while avoiding unnecessary decompression unless clear impingement exists. Postoperative care emphasizes early motion, cautious progression of resistance training, and careful physical therapy to avoid stiffness and pain exacerbation. Occasionally, repeat cortisone injections and home exercise programs are used.<br /><br />The summary stresses treating symptoms rather than radiographic findings, adopting a stepwise approach to delay invasive procedures, and maintaining activity levels. While no cure exists, evolving treatment options and implants offer hope for improved management. The overall goal is symptom control and activity preservation in young patients with shoulder arthritis.

Keywords

gleno-humeral arthritis

young patients

causes of shoulder arthritis

inflammatory diseases

trauma-related arthritis

arthroscopic treatment

conservative management

physical therapy

postoperative care

symptom control