Clinical outcomes after microfracture of the glenohumeral joint.
BACKGROUND
Microfracture is an effective surgical treatment for isolated, full-thickness cartilage defects with current data focused on applications in the knee. No studies describing clinical outcomes of patients who have undergone microfracture in the shoulder joint have been reported.


OBJECTIVE
Treatment of glenohumeral joint articular defects using microfracture would demonstrate similar short-term clinical outcomes when compared with other joints.


METHODS
Case series; Level of evidence, 4.


METHODS
From March 2001 to August 2007, 16 patients (17 shoulders) who underwent arthroscopic microfracture of the humeral head and/or glenoid surface were retrospectively reviewed. All patients were examined by an independent, blinded examiner and completed surveys containing the Simple Shoulder Test (SST), American Shoulder and Elbow Score (ASES), and visual analog scale (VAS).


RESULTS
Two patients were lost to follow-up, for a follow-up rate of 88%. Three patients went on to subsequent shoulder surgery and were considered to have failed results. The mean age was 37.0 years (range, 18-55 years) with an average follow-up of 27.8 months (range, 12.1-89.2 months). The average size of humeral and glenoid defects was 5.07 cm(2) (range, 1.0-7.84 cm(2)) and 1.66 cm(2) (range, 0.4-3.75 cm(2)), respectively. There was a statistically significant decrease from 5.6 +/- 1.7 to 1.9 +/- 1.4 (P < .01) in VAS after surgery as well as statistically significant improvements (P < .01) in SST (5.7 +/- 2.1 to 10.3 +/- 1.3) and ASES (44.3 +/- 15.3 to 86.3 +/- 10.5). Twelve (92.3%) patients claimed they would have the procedure again.


CONCLUSIONS
Microfracture of the glenohumeral joint provides a significant improvement in pain relief and shoulder function in patients with isolated, full-thickness chondral injuries. Longer term studies are required to determine if similar results are maintained over time.
Frank
Rachel M
RM
Rush University Medical Center, Chicago, IL 60612, USA.
Van Thiel
Geoffrey S
GS
Slabaugh
Mark A
MA
Romeo
Anthony A
AA
Cole
Brian J
BJ
Verma
Nikhil N
NN
D000293:Adolescent; D000328:Adult; D054544:Arthroplasty, Subchondral; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000601:surgery; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012782:Shoulder / Q000502:physiology; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult