2023 ISAKOS Biennial Congress ePoster
Surgical Treatment Options For Articular Cartilage Defects Of The Glenohumeral Joint: A Systematic Review
Moin Khan, MD, MSc, FRCSC, Hamilton, ON CANADA
Danielle Dagher, BHSc, Scarborough, ON CANADA
Asher Selznick CANADA
Carlos Prada, MD, London, Ontario CANADA
Yasser Al Shehab SAUDI ARABIA
Timothy Leroux, MD, MEd, FRCSC, Toronto CANADA
McMaster University , Hamilton, ON, CANADA
FDA Status Not Applicable
Summary
The purpose of this review is to assess the outcomes of different joint-preserving surgical interventions in patients with focal chondral lesions of the GH joint.
ePosters will be available shortly before Congress
Abstract
Purpose
The purpose of this systematic review was to evaluate the reported outcomes of joint-preserving surgical procedures in patients with focal chondral lesions of the glenohumeral joint.
Methods
A comprehensive literature search was conducted using PubMed, Embase, and Medline. Patients were included if they underwent a joint-preserving surgical procedure to treat a focal chondral defect of the glenoid, humeral head or both. Patients were excluded if they were being treated for a diffuse cartilage defect, or if they were treated with a shoulder arthroplasty. Study characteristics, patient demographics, and outcome data were collected.
Results
Ten studies were included in this review, with follow-up data available for 194 shoulders in 191 patients. Eight types of joint-preserving surgical procedures were evaluated, with microfracture being the most commonly used. Patient-reported and functional outcomes were reported in all studies. One study evaluating microfracture reported significant improvements in VAS, ASES, and SST scores at both short-term (VAS: P = .003; ASES: P = .006; SST: P = .009) and long-term (VAS: P = .007; ASES: P = .014; SST: P = .009) follow-up when compared to preoperative scores. Across all studies, a total of 32 patients (16%) underwent subsequent shoulder surgery, with 22 (69%) of these reoperations being shoulder arthroplasties.
Conclusions
The findings of this systematic review demonstrate improvements in patient-reported and functional outcomes across all studies. Although joint-preserving procedures have shown reasonable outcomes for focal chondral defects of the GH joint, their long-term outcomes are still unknown. Progression of OA remains a concern that should be discussed with this patient population. Future studies with higher quality evidence are required to make definitive recommendations.