ICL 207 Glenhumeral Arthritis in the Young Patient: Arthroscopic and Other Options-Joint Preservation Options for Shoulder Osteoarthritis in Young, Active Patients

Joint Preservation Options for Shoulder Osteoarthritis in Young, Active Patients

Video Transcription

Video Summary

The speaker discusses joint-preserving, non-arthroplasty treatment options for young patients with degenerative shoulder joint disease, highlighting the challenges and limitations of total shoulder arthroplasty in younger populations due to implant durability and revision complications. Key approaches include arthroscopic procedures such as microfracture for focal cartilage defects, which improve pain and function but yield moderate outcomes compared to rotator cuff repairs. For bone involvement, options include osteochondral allografts or partial prosthetic replacements. Diffuse osteoarthritis may be managed with arthroscopic debridement, capsule releases, and a novel humeral osteoplasty (CAM procedure) that reduces axillary nerve compression by removing inferior osteophytes, improving motion and decreasing pain. The procedure shows promising medium-term survivorship (73-85% at 2-5 years). Decision analysis supports arthroscopy under age 47, arthroplasty over 65, and either between 47-65. Patient selection, expectations, and preserving future surgical options are critical. Emerging biologic grafts and partial replacements offer additional avenues to delay arthroplasty in young active patients.

Keywords

joint-preserving treatment

non-arthroplasty shoulder options

arthroscopic microfracture

osteochondral allografts

humeral osteoplasty CAM procedure

young patients shoulder osteoarthritis