Shoulder Arthritis In Young Active Patients - What Are The Best Options? (2021 Annual Meeting)-Shoulder Arthritis In Young Active Patients

Video Transcription

Video Summary

The presentation and panel discussion focused on managing shoulder arthritis in young patients, emphasizing arthroscopic, biological, and arthroplasty treatment options. Dr. Erickson outlined arthroscopic interventions such as joint lavage, biceps tenodesis, capsular release, and the comprehensive arthroscopic management (CAM) procedure. The CAM procedure—comprising chondroplasty, osteophyte removal, capsular release, subacromial decompression, and biceps tenodesis—demonstrates the most evidence-based success, offering significant pain relief, improved range of motion, and delaying arthroplasty by up to 10 years in selected patients.<br /><br />Dr. Mattson discussed biological options, highlighting challenges in young patients with post-traumatic or inflammatory arthritis. Biologic resurfacing using grafts like lateral meniscus allografts, acellular dermal matrices, and fresh osteochondral allografts (e.g., fresh talus or distal tibia) can improve symptoms but often require future procedures due to limited long-term durability. Microfracture and cartilage repair techniques provide some benefits in focal lesions, yet patient selection remains critical.<br /><br />Dr. Sam provided insight into arthroplasty, arguing total shoulder arthroplasty (TSA) as the optimal intervention for advanced cases, with hemiarthroplasty and Riemann run offering limited benefits. TSA yields high return-to-sport rates and quality-of-life improvements; however, complications and revision surgeries are expected, especially in younger patients. Preoperative imaging—particularly CT with 3D reconstructions—is essential for surgical planning. Managing glenoid version, bone cysts, and subscapularis repair are critical technical steps.<br /><br />Panelists stressed individualized treatment balancing delaying arthroplasty with maintaining function and quality of life. Non-arthroplasty options may buy time but should not compromise future TSA outcomes. Proper patient selection, setting realistic expectations, and recognizing arthritis subtype differences are key to optimizing care in young patients with shoulder arthritis.

Asset Caption

Anthony A. Romeo, M.D. | Brandon J. Erickson, M.D. | Matthew T. Provencher, M.D. | Samuel A. Taylor, M.D.

Keywords

shoulder arthritis

young patients

arthroscopic treatment

biological treatment

arthroplasty

joint lavage

biceps tenodesis

capsular release

comprehensive arthroscopic management (CAM)

biologic resurfacing

total shoulder arthroplasty (TSA)

preoperative imaging

patient selection