title: Retrospective analysis of arthroscopic management of glenohumeral degenerative disease.
abstract: OBJECTIVE
  The purpose of this study was to examine the results of arthroscopic debridement for isolated degenerative joint disease of the shoulder.
  
  
  METHODS
  We retrospectively identified 81 patients who had arthroscopic debridement to treat glenohumeral arthritis. Of these patients, 71 (88%) were available for follow-up. The preoperative Simple Shoulder Test score, American Shoulder and Elbow Surgeons score, Short Form 12 score, visual analog scale score for pain, and range of motion were recorded. These were compared against postoperative scores by use of the statistical paired t test. In addition, patients completed postoperative University of California, Los Angeles; Constant; and Single Assessment Numeric Evaluation scores. Forty-six preoperative radiographs were blindly evaluated and classified. Finally, the need for subsequent shoulder arthroplasty was recorded.
  
  
  RESULTS
  The mean follow-up for the 55 patients who did not progress to arthroplasty was 27 months. The mean preoperative and postoperative American Shoulder and Elbow Surgeons, Simple Shoulder Test, and pain visual analog scale scores all significantly improved (P < .05). Furthermore, range of motion significantly improved (P < .05) in flexion, abduction, and external rotation. Additional postoperative scores were as follows: University of California, Los Angeles, 28.3; Single Assessment Numeric Evaluation, 71.1; Constant score for affected shoulder, 72.0; and Constant score for unaffected shoulder, 78.5. Of the patients, 16 (22%) underwent arthroplasty at a mean of 10.1 months after debridement. Radiographic review showed that 13 shoulders with a mean joint space of 1.5 mm and grade 2.4 arthrosis went on to have shoulder arthroplasty. In contrast, 33 shoulders with a mean joint space of 2.6 mm and grade 1.9 arthrosis did not go on to have shoulder arthroplasty.
  
  
  CONCLUSIONS
  Patients with residual joint space and an absence of large osteophytes can avoid arthroplasty and have increased function with decreased pain after arthroscopic debridement for degenerative joint disease. Significant risk factors for failure include the presence of grade 4 bipolar disease, joint space of less than 2 mm, and large osteophytes.
  
  
  METHODS
  Level IV, case series.
authors.affiliation: Rush University Medical Center, 720 N Larrabee, Chicago, IL 60654, U.S.A. Geoffrey_vanthiel@rush.edu
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Van Thiel
authors.forename: Steven
authors.initials: S
authors.lastname: Sheehan
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Frank
authors.forename: Mark
authors.initials: M
authors.lastname: Slabaugh
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Nicholson
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Romeo
authors.forename: Nikhil N
authors.initials: NN
authors.lastname: Verma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult