Surgical Treatment Options for Glenohumeral Arthritis in Young Patients: A Systematic Review and Meta-analysis

Abstract

Level IV, systematic review of Level IV studies.

Pyrocarbon interposition shoulder arthroplasty in young arthritic patients: a prospective observational study

“…10 There is a lack of consensus regarding implant choice in the young arthritic shoulder. 1,38 The problem with total shoulder arthroplasty in young arthritic patients is the high rate of glenoid loosening (up to 50% at 10 years), which can lead to severe glenoid bone loss and complex revision procedures. 33 Biologic glenoid resurfacing, using meniscal allograft, capsular interposition, or synthetic membrane, has resulted in disappointing results.…”

Long-term Clinical Outcomes After Microfracture of the Glenohumeral Joint: Average 10-Year Follow-up

“…result in debilitating shoulder pain and disability often require operative management, with surgical options ranging from minimally invasive arthroscopic techniques to shoulder arthroplasty. 27 Marrow stimulation surgery, including microfracture, has been identified as a promising potential alternative to arthroplasty in a younger patient population. 9,27 Microfracture surgery has been used with success in the knee and ankle, and long-term outcomes of this procedure have been reported in both these joints.…”

“…27 Marrow stimulation surgery, including microfracture, has been identified as a promising potential alternative to arthroplasty in a younger patient population. 9,27 Microfracture surgery has been used with success in the knee and ankle, and long-term outcomes of this procedure have been reported in both these joints. 22,23,31 This technique has been established as an effective first-line option for isolated full-thickness cartilage defects given its technical ease and low overall complication rate.…”

“…22,23,31 This technique has been established as an effective first-line option for isolated full-thickness cartilage defects given its technical ease and low overall complication rate. 9,27,31 Multiple investigations have reported on the use of microfracture in the management of glenohumeral cartilage lesions. 9,[18][19][20]27,30 Specifically, Frank et al 9 reported significant improvements in pain relief and shoulder function, with an overall 80% success rate at early clinical follow-up (average, 27.8 months).…”

Prevention and management of post-instability glenohumeral arthropathy

“…Despite initial concerns over the possibility of glenoid loosening, recent studies have shown that patients have a significantly increased return to sports after TSA compared to HA[101,102]. Large meta-analysis of pooled data has also demonstrated that TSA provides greater pain improvement and increased range of motion compared to HA in young patients with glenohumeral arthritis[103]. Certainly, the young patient with arthritis is very difficult to treat with any arthroplasty modality, and outcomes in this population are worse than standard arthroplasty patients[87,104].…”