Arthroscopic Management of Glenohumeral Arthritis

Glenohumeral arthritis is one of the most common forms of arthritis and, when present, may lead to debilitating pain and loss of function for patients. When conservative management fails to provide adequate relief, surgery is indicated. Typically, this consists of either anatomic or reverse shoulder arthroplasty. However, there are functional limitations that patients must abide by after undergoing shoulder arthroplasty surgery to maximize implant longevity. Therefore, in a young and active subset of patients with glenohumeral arthritis who are unwilling or unable to modify their activities accordingly, arthroscopic surgery can be considered. Arthroscopic management of glenohumeral arthritis has been termed osteocapsular arthroplasty, comprehensive arthroscopic management, or simply arthroscopic debridement surgery. Regardless of the name, the procedure consists of diagnostic arthroscopy followed by focused treatment of the myriad of pathologic tissues in the arthritic joint, including soft tissues, for example with synovectomy and capsulotomy, and osseous tissues, for example with osteophyte resection and glenoidplasty. This advanced arthroscopic procedure requires the use of unique surgical portals, such as the anteroinferior and posteroinferior portals, which can place the axillary nerve at risk. Arthroscopic management of glenohumeral arthritis is a valuable surgical option for young, active, high-demand patients with shoulder arthritis.