ICL 207 Glenhumeral Arthritis in the Young Patient: Arthroscopic and Other Options-Realistic Options in the Degenerative Shoulder in an Active Population

Realistic Options in the Degenerative Shoulder in an Active Population

Video Transcription

Video Summary

The speaker discusses managing osteoarthritis in younger patients (under 60), emphasizing the limitations of traditional treatments like supplements, injections, and arthroscopic debridement, which serve mainly to buy time. They highlight the challenges of severe arthritis in active patients, noting that total shoulder replacements work better after age 60 due to durability concerns and activity limitations. For younger patients, less invasive staged approaches are preferable, starting with non-operative management and progressing to arthroscopic debridement. When this fails, resurfacing using dermal patches on the glenoid offers pain relief and improved function for properly selected patients with a round humeral head. For those with a deformed head, a subscapularis-sparing mini-open procedure preserves muscle function, enabling faster rehabilitation and better activity outcomes. Long-term follow-ups show good success with these techniques, enabling patients to maintain active lifestyles and delay total shoulder arthroplasty until older age. Overall, the approach is stepwise, aiming to preserve joint function while accommodating patients' activity demands.

Keywords

osteoarthritis management

younger patients

shoulder resurfacing

arthroscopic debridement

subscapularis-sparing procedure

joint preservation