Survivorship after Arthroscopic Management of Glenohumeral Osteoarthritis with a Minimum 5 year Follow-up

Abstract

Introduction: The outcomes and durability of arthroscopic treatment for glenohumeral osteoarthritis(GHOA) are not well studied. The purpose was to determine 5 yr survivorship for a comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA. Methods: This study had prior IRB approval. The CAM procedure was performed on a consecutive series of 42 young patients(44 shoulders) with GHOA. All patients had clinical and radiographic features, which would otherwise qualify them for total shoulder arthroplasty( TSA). The CAM procedure included glenohumeral chondroplasty, capsular release, and synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture and biceps tenodesis. Patients a minimum of 5 years out from surgery were included. Outcomes scores were collected including ASES and satisfaction. Failure was defined as progression to TSA. Kaplan Meier survivorship analysis was performed. Results: Results: 42 patients (with 44 shoulders) were included. All were recreational athletes. 7 were former collegiate or professional athletes. Mean age at surgery was 52yrs (range,27 to 68), with 13 women and 29 men. The mean follow-up on 86% of the cohort was 6yrs (range,5 to 8). 11 shoulders(26%) progressed to TSA, at a mean of 2.9 yrs (1.0-5.4). One progressed to another surgery for stiffness at a mean of 5.6 months, and another underwent a revision CAM procedure at 7.9 yrs. Mean pre-op ASES score was 64.5(SD+11.6) and 86.7(SD+16.6) at final follow-up. Median satisfaction was 10 (range,2-10). From this cohort, Kaplan Meier survivorship was 84.6% at 3 yrs and 73.3% survivorship at 5 yrs. Conclusion: The long term durability of arthroscopic management for symptomatic GHOA is important to understand for proper surgical decision-making, particularly in young patients with GHOA. At a mean of 6 yrs and minimum of 5 yrs after the CAM procedure, we found acceptable outcomes scores with survivorship at 3 years of 84.6% and at 5 yrs of 73.3%.