Evaluation of the results from non-arthroplastic treatment (arthroscopy) for shoulder arthrosis

Abstract

ObjectivesTo evaluate the functional results from patients with arthrosis who underwent an arthroscopic procedure, in an attempt to correlate these results with the patients’ epidemiological profile, surgical technique used, possible complications and postoperative protocol.MethodsBetween 1998 and 2011, 31 patients (32 shoulders) with shoulder arthrosis underwent arthroscopic treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology of Santa Casa de São Paulo. Primary or secondary cases of shoulder arthrosis under the age of 70 years, in which the rotator cuff was intact, were included. Furthermore, cases in which, despite an indication for an arthroplastic procedure, an attempt to perform an alternative procedure had been chosen, were also included. The following were evaluated: sex, age, dominance, comorbidities, length of time with complaint, associated lesions, etiology, previous treatment, operation performed, postoperative protocol and pre and postoperative active ranges of motion. The functional evaluation was conducted using the UCLA criteria, before and after the operation. The joint cartilage alterations were classified in accordance with Outerbridge and the arthrosis by means of Walch.ResultsThere were statistically significant mean differences in the values for elevation, lateral rotation and medial rotation from before to after the operation (p < 0.001) and there was a tendency (p = 0.057) toward poor results with greater length of time with complaints before the surgery. The total gain in UCLA score did not have any statistically significant relationship with any of the other variables analyzed.ConclusionArthroscopic treatment of glenohumeral arthrosis provided functional improvement of the glenohumeral joint, with significant gains in elevation and lateral and medial rotation, and improvements in function and pain. Greater length of time with complaints was a factor strongly suggestive of worse results.

Arthroscopic bursectomy less effective in the degenerative shoulder with chronic subacromial pain

“…In line with literature, we found that longer duration of preoperative complaints was associated with an unfavorable course of SAPS after surgical bursectomy. 20 , 25 , 33 , 36 Interestingly, the peroperative identification of glenoid degeneration was also identified as a negative predictor for patient-reported outcomes after arthroscopic subacromial bursectomy. These results indicate that arthroscopic bursectomy on the nondegenerative shoulder joint results in better patient-reported outcomes compared with the degenerative shoulder.…”