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Surgical options for the young patient with glenohumeral arthritis


1 Department of Orthopaedics, The Ohio State University, Wexner Medical Center, Columbus, OH, USA
2 Department of Orthopaedic Surgery, The Rothman Insitute, Philadelphia, PA, USA

Correspondence Address:
Jonathan D Barlow
3200 OSU Hand Center, 915 Olentangy River Road, Columbus, OH 43212
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.174516

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Year : 2016  |  Volume : 10  |  Issue : 1  |  Page : 28-36

 

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Young patients with glenohumeral arthritis are an ongoing treatment challenge. They typically have high demands of their shoulders, require long-term durability due to their young age, and often have altered local anatomy, through their disease process (instability arthropathy, juvenile rheumatoid arthritis, etc.) or from previous surgery (capsulorraphy arthropathy, chondrolysis, etc.). Workup to evaluate underlying causes of early arthritis, and to exclude infectious causes are necessary. When nonoperative management fails, arthroscopic debridement, hemiarthroplasty (isolated, with glenoid reaming, or with biological interposition), and total shoulder arthroplasty are treatment options available to the treating surgeon. Debridement or hemiarthroplasty can provide pain relief for a subset of patients, but results have not been reproducible across the literature and have not been durable over time. Total shoulder arthroplasty provides the most reliable pain relief, but long-term glenoid loosening and wear continue to lead to high revision rates in this patient population.






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1 Department of Orthopaedics, The Ohio State University, Wexner Medical Center, Columbus, OH, USA
2 Department of Orthopaedic Surgery, The Rothman Insitute, Philadelphia, PA, USA

Correspondence Address:
Jonathan D Barlow
3200 OSU Hand Center, 915 Olentangy River Road, Columbus, OH 43212
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.174516

Rights and Permissions

Young patients with glenohumeral arthritis are an ongoing treatment challenge. They typically have high demands of their shoulders, require long-term durability due to their young age, and often have altered local anatomy, through their disease process (instability arthropathy, juvenile rheumatoid arthritis, etc.) or from previous surgery (capsulorraphy arthropathy, chondrolysis, etc.). Workup to evaluate underlying causes of early arthritis, and to exclude infectious causes are necessary. When nonoperative management fails, arthroscopic debridement, hemiarthroplasty (isolated, with glenoid reaming, or with biological interposition), and total shoulder arthroplasty are treatment options available to the treating surgeon. Debridement or hemiarthroplasty can provide pain relief for a subset of patients, but results have not been reproducible across the literature and have not been durable over time. Total shoulder arthroplasty provides the most reliable pain relief, but long-term glenoid loosening and wear continue to lead to high revision rates in this patient population.






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