Arthroscopic management of glenohumeral osteoarthritis: A systematic review of clinical outcomes and treatment durability

Marko Nabergoj; Patrick Denard; Philippe Collin; Floris Van Rooij; Alexandre Lädermann

DOI: 10.70885/hmsj.2025.03.002

Abstract

Background: Glenohumeral osteoarthritis (GHOA) is a degenerative condition causing pain and functional impairment. While total shoulder arthroplasty (TSA) is the standard treatment for end-stage disease, younger and active patients often seek joint-preserving alternatives. Various arthroscopic techniques, including comprehensive arthroscopic management (CAM), debridement, and interposition arthroplasty, have been explored, but their efficacy and durability remain unclear.Purpose: To systematically review the clinical outcomes, pain relief, functional improvement, and conversion rates to TSA following arthroscopic treatment for GHOA.Methods: A systematic search in Medline® and Embase identified studies published in the last 20 years on arthroscopic treatment for GHOA. Data on demographics, surgical techniques, outcome measures (ASES scores, VAS pain scores), and conversion rates to TSA were extracted. Study quality was assessed using the Joanna Briggs Institute checklist, and heterogeneity was evaluated using the I² statistic.Results: Seventeen studies (727 patients, aged 32–59) were included, covering debridement (7 studies), CAM (5), interposition arthroplasty (4), and capsulotomy (1). Pooling of the data revealed a postoperative ASES following CAM of 81.9, and debridement of 64.1, although the differences were not statistically significant. The postoperative pain on VAS ranged between 2 and 7.4 following debridement, 1.3 and 3.3 following CAM, and 2 following interposition arthroplasty. Conversion rates to TSA were lowest for CAM (22%) compared to debridement (25%) and interposition arthroplasty (34%), though statistical significance was not achieved due to study heterogeneity.Conclusion: Arthroscopic management of glenohumeral osteoarthritis can provides meaningful pain relief and functional improvement and may delay TSA. However, durability remains uncertain. Standardized protocols and prospective studies are needed to optimize patient selection and treatment strategies.What this study adds: This review identifies CAM as an effective arthroscopic approach for GHOA.Potential impacts on research, practice, or policy: Findings support CAM as a viable joint-preserving option, emphasizing the need for standardized evaluation, longer follow-up, and improved patient selection criteria.Study design: Systematic reviewLevel of Evidence: Level IVKeywords: Glenohumeral osteoarthritis; Arthroscopy; Comprehensive arthroscopic management; Interposition arthroplasty; Debridement; Joint preservation.https://doi.org/10.70885/hmsj.2025.03.002

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