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

Video Transcription

Video Summary

In this expert discussion on managing young patients with severe shoulder lesions, the panel highlights a multi-step approach aiming to "buy time" before more invasive procedures like total shoulder replacement. For 30-year-olds with grade 4 lesions, initial treatments such as debridement and cortisone shots may delay surgery by 2-5 years. Glenoid and humeral resurfacing can extend function for another 5-10 years each, ideally postponing total replacement until around age 65. Complex cases, including posterior subluxation and biconcave glenoids, pose significant surgical challenges requiring individualized solutions, such as posterior grafting or bone block procedures. Biologic treatments like PRP and hyaluronic acid injections have been tried with mixed results and insurance coverage hurdles. While biologic glenoid resurfacing shows promising cartilage regeneration, outcomes vary. The panel stresses the importance of patient selection and staged interventions to manage young, active patients’ shoulder arthritis, balancing pain relief, function, and durability of interventions.

Keywords

severe shoulder lesions

young patients

shoulder resurfacing

biologic treatments

staged interventions