Options in joint-preserving surgical treatment of osteoarthritis

Abstract

The treatment of glenohumeral arthritis represents amajor challenge in highly active younger patients. In these patients, an endoprosthetic treatment often achieves only unsatisfactory results with a limited lifetime of the implant. The aim of the study was to identify joint-preserving therapies for glenohumeral arthritis. For this study, an extensive and selective literature search was performed. There are several options available for joint-preserving treatment of glenohumeral arthritis. In addition to arthroscopic debridement with treatment of concomitant pathologies, CAM procedures (CAM: comprehensive arthroscopic management) according to Millett, as well as the interposition of allografts are other options. For all therapy options, an improved range of motion and pain reduction is described. Ajoint gap of <2 mm, bipolar cartilage lesions and age are described as risk factors for failure of the therapies. Short and mid-term results have been described for arthroscopic debridement, but there are no long-term and high-quality studies to enable us to make clear recommendations. The CAM procedure and the interposition of an allograft are demanding procedures that should be reserved for experienced arthroscopists. The therapies are an option for younger patients in accordance with individual decisions and realistic expectations.