Positive outcomes seen up to 5 years following CAM procedures in patients with glenohumeral OA
ORLANDO, Fla. — According to Justin Mitchell, MD, and his colleagues, comprehensive arthroscopic management procedures to treat patients with glenohumeral osteoarthritis produced positive outcomes up to 5 years postoperatively.
“[This group of patients] demonstrated good pain relief, significant improvements in patient-centered outcome scores and they have high patient satisfaction,” Mitchell said in his presentation.
Mitchell and his colleagues conducted an IRB-approved study of 44 shoulders in 42 patients (mean age at surgery: 52 years) with glenohumeral osteoarthritis who underwent a comprehensive arthroscopic management (CAM) procedure between January 2006 and December 2009. This procedure included glenohumeral chondroplasty, capsular release, synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture and biceps tenodesis. All patients were recreational athletes (seven patients were former collegiate or professional athletes) and at least 5 years removed from the CAM procedure. Mean follow-up for the study was 5.9 years.
Any further surgical treatment of the treated shoulder was noted in 38 of 44 patients (86%), and CAM failure was defined as progression to total shoulder arthroplasty (TSA). Patients also completed a subjective questionnaire, and researchers performed a Kaplan Meier survivorship analysis.
Progression to TSA was found in 11 shoulders (26%) at a mean of 2.9 years postoperatively. Revision CAM was performed in one patient at 7.9 years after the index procedure, and another patient underwent a second stiffness-related procedure at a mean of 5.6 months postoperatively. Postoperative Kaplan Meier survivorship was observed as 92% at 1 year, 85% at 3 years and 73% at 5 years.
Joint space of more than 2 mm, glenoid morphology and CSA greater than 30° were associated with better outcomes, Mitchell and colleagues found.
“For patients looking for alternative to total shoulder arthroplasty, especially in this young group of patients, the CAM procedure can provide reasonable outcomes in appropriately selected active patients,” Mitchell said. — by Christian Ingram
Millett PJ, et al. Paper #322. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla.
Disclosure: Mitchell reports no relevant financial disclosures.