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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Relationship between probability of future shoulder arthroplasty and outcomes of arthroscopic debridement in patients with advanced osteoarthritis of glenohumeral joint

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2015
Autoren:
Patrick Henry, Helen Razmjou, Tim Dwyer, Jesse A. Slade Shantz, Richard Holtby
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests. No external funding was received for this study.

Authors’ contributions

HR conceived the idea, supervised data extraction and entry, and performed data analysis. PH reviewed the literature and drafted the manuscript. TD and JASS reviewed the files of the patients for future replacement surgeries. RH conducted surgery on all patients. All authors have contributed to data analysis interpretation and manuscript preparation and have read and approved the final manuscript.

Authors’ information

Not applicable.

Abstract

Background

Arthroscopic glenohumeral debridement for symptom control has shown promising short term results in the young active population, when arthroplasty may not be a practical option due to the recommended activity restrictions, potential for complications and/or early wear, and a need for revision. The purpose of this study was twofold: 1) to examine the impact of arthroscopic debridement with or without subacromial decompression on clinical outcomes in patients with severe glenohumeral osteoarthritis (OA), and 2) to explore the differences in post-debridement outcomes between patients who eventually progressed to arthroplasty vs. those who did not. The role of an active worker’s compensation claim was examined.

Methods

Prospectively collected data of patients who were not good candidates for shoulder arthroplasty and had subsequently undergone arthroscopic shoulder debridement were used for analysis. Disability was measured using the relative Constant-Murley score (CMS), the American Shoulder and Elbow Surgeon’s (ASES) assessment form, pain free range of motion (ROM), and strength.

Results

Fifty-six patients were included in the final analysis. Eighteen (32 %) patients underwent arthroplasty surgery (arthroplasty group) over a period of 11 years. The arthroplasty group was comparable with the non-arthroplasty group prior to debridement but was more disabled at post-debridement surgery follow-up, functioning at less than 50 % of normal based on ASES, relative CMS, and active painfree ROM. In the multivariable analysis, the post-debridement relative CMS was affected by having a compensation claim and having a future arthroplasty.

Conclusion

Arthroscopic debridement improved clinical outcome in 68 % of patients suffering from advanced OA of glenohumeral joint. Having less than 50 % of normal score in ASES, relative CMS and painfree ROM post- debridement within a period of two years may be an indication for future arthroplasty. Role of worker’s compensation claims should not be underestimated.
Literatur
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