Management of glenohumeral arthritis: A role for arthroscopy?

When nonoperative measures fail in the treatment of glenohumeral arthritis, arthroscopy has emerged as a viable therapeutic option. It is valuable as a diagnostic and therapeutic intervention and has a low morbidity and low complication rate. Arthroscopic techniques can be performed in the younger patient or athlete wishing to delay arthroplasty or in the elderly patient with associated comorbidities wishing to avoid a larger operation. In those with inflammatory arthropathies, arthroscopy with associated debridement and synovectomy can relieve pain, improve function, and delay progression of the disease. In the athlete and young patient with osteoarthritis, arthroscopy allows recognition and treatment of coexisting pathologies in which procedures such as subacromial decompression and capsular release have proven to be of benefit. Arthroscopic debridement, abrasion arthroplasty, and microfracture techniques seem to be of some benefit; however, it remains unclear who the ideal candidate is. Overall it is generally viewed that patients improve and benefit most when intervention is early in the course of the disease. Although the role of arthroscopy in the treatment of glenohumeral arthritis is evolving, in certain situations and patients it is thus a viable option and another tool in the armamentarium of the orthopedic surgeon.