Pearls for thorough debridement, capsular release, and role of microfracture

Abstract

Arthroscopic treatment of glenohumeral arthritis has become an increasingly popular treatment option particularly in young patients that are active and wish to either delay or avoid total shoulder replacement. The optimal treatment remains to be determined. However, multiple studies have shown improved outcomes, pain scores, range of motion, and patient satisfaction with arthroscopic debridement and a capsular release. In addition, microfracture has been shown to be helpful for isolated cartilage lesions. Capsular release reliably increases range of motion. Bipolar lesions, a joint space less than 2 mm on radiographs, and a biconcave glenoid have been associated with inferior outcomes. The goal of this chapter is to review the role of debridement, microfracture, and capsular release in treating glenohumeral arthritis. The authors’ preferred operative technique will be discussed along with technical pearls.