Arthroscopic Capsular Release and Debridement of Painful Shoulder Osteoarthritis Can Improve Symptoms and Delay Arthroplasty: A Mid- to Long-term Follow-up Study

Abstract Hypothesis In patients with symptomatic osteoarthritis of the shoulder, arthroscopic debridement and capsular release will provide relief of symptoms and improvement in function for a minimum of two years. Methods Prospective outcome data was collected from patients who underwent arthroscopic debridement and capsular release for painful idiopathic glenohumeral arthritis from 2005 to 2013 by one surgeon. The primary outcome was conversion to shoulder arthroplasty. UCLA and Simple Shoulder Test (SST) scores were also collected by phone or mailing. Preoperative radiographs were evaluated for Samilson and Prieto classification and Walch glenoid classification. Results Thirty-three of 40 patients (82.5%) who met inclusion criteria with an average time since surgery of 6.4 years (range, 2-10 years) were reached for final follow-up. Eight of 33 respondents (24.2%) had conversion to arthroplasty within the study period at an average 1.75 ± 2.37 years (range, 0.5-7 years) postoperatively. Nine patients (36%) reported no pain at the time of survey. Of patients who reported current pain (16/25, 64%), seven (43.7%) had improved pain since surgery. For patients with preoperative UCLA scores, scores were significantly higher at mid-term (p=0.003) and long-term (p=0.017) follow-up. Patients who were less than 8 years since surgery had significantly higher SST (2-4 years, p=0.004; 5-7 years, p=0.024) and UCLA (2-4 years, p=0.004; 5-7 years, p=0.011) scores than those who were 8-10 years since surgery. There were no significant differences in preoperative radiographic classifications and outcome. Conclusion Arthroscopic debridement with capsular release in certain patients with osteoarthritis of the shoulder can provide long-term pain reduction, increased function, and can delay shoulder arthroplasty. Level of Evidence Level IV; Prognostic Study; Case Series