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Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 5-Year Follow-up

Background: There are little data on midterm outcomes after the arthroscopic management of glenohumeral osteoarthritis (GHOA) in young active patients. Purpose: To report outcomes and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at a minimum of...

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Published in:The American journal of sports medicine 2016-12, Vol.44 (12), p.3206-3213
Main Authors: Mitchell, Justin J., Horan, Marilee P., Greenspoon, Joshua A., Menge, Travis J., Tahal, Dimitri S., Millett, Peter J.
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container_end_page 3213
container_issue 12
container_start_page 3206
container_title The American journal of sports medicine
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creator Mitchell, Justin J.
Horan, Marilee P.
Greenspoon, Joshua A.
Menge, Travis J.
Tahal, Dimitri S.
Millett, Peter J.
description Background: There are little data on midterm outcomes after the arthroscopic management of glenohumeral osteoarthritis (GHOA) in young active patients. Purpose: To report outcomes and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at a minimum of 5 years postoperatively. Study Design: Case series; Level of evidence, 4. Methods: The CAM procedure was performed on a consecutive series of 46 patients (49 shoulders) with advanced GHOA who met criteria for shoulder arthroplasty but instead opted for a joint-preserving, arthroscopic surgical option. The procedure included glenohumeral chondroplasty, capsular release, synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture, and biceps tenodesis. Outcome measures included the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form–12 (SF-12) Physical Component Summary (PCS), visual analog scale for pain, and satisfaction scores. Kaplan-Meier survivorship analysis was performed with failure defined as progression to total shoulder arthroplasty (TSA). Results: Forty-six consecutive patients (49 shoulders) who underwent a CAM procedure at a minimum of 5 years from surgery were included. Two patients were excluded for refusing to participate before study initiation. The mean age at surgery was 52 years (range, 27-68 years) in 15 women and 29 men. All patients were recreational athletes with 7 former collegiate or professional athletes. Twelve shoulders (26%) progressed to TSA at a mean of 2.6 years (range, 0.5-8.2 years). For survivorship analysis, the status of the shoulder (preservation of the native joint or progression to TSA) at a minimum of 5 years was known for 45 of 47 (96%) shoulders. Survivorship was 95.6% at 1 year, 86.7% at 3 years, and 76.9% at 5 years. For surviving shoulders, minimum 5-year subjective outcome data were available for 28 of 32 (87.5%) shoulders at a mean of 5.7 years (range, 5-8 years). The mean (±SD) ASES score was 84.5 ± 17, the mean SANE score was 82 ± 18, the mean QuickDASH score was 15 ± 13, the mean SF-12 PCS score was 51.0 ± 9.1, and median patient satisfaction was 9 of a possible 10 points. Conclusion: This study demonstrates significant improvements in midterm clinical outcomes and high patient satisfaction after the arthroscopic CAM procedure for GHOA, wit
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Purpose: To report outcomes and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at a minimum of 5 years postoperatively. Study Design: Case series; Level of evidence, 4. Methods: The CAM procedure was performed on a consecutive series of 46 patients (49 shoulders) with advanced GHOA who met criteria for shoulder arthroplasty but instead opted for a joint-preserving, arthroscopic surgical option. The procedure included glenohumeral chondroplasty, capsular release, synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture, and biceps tenodesis. Outcome measures included the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form–12 (SF-12) Physical Component Summary (PCS), visual analog scale for pain, and satisfaction scores. Kaplan-Meier survivorship analysis was performed with failure defined as progression to total shoulder arthroplasty (TSA). Results: Forty-six consecutive patients (49 shoulders) who underwent a CAM procedure at a minimum of 5 years from surgery were included. Two patients were excluded for refusing to participate before study initiation. The mean age at surgery was 52 years (range, 27-68 years) in 15 women and 29 men. All patients were recreational athletes with 7 former collegiate or professional athletes. Twelve shoulders (26%) progressed to TSA at a mean of 2.6 years (range, 0.5-8.2 years). For survivorship analysis, the status of the shoulder (preservation of the native joint or progression to TSA) at a minimum of 5 years was known for 45 of 47 (96%) shoulders. Survivorship was 95.6% at 1 year, 86.7% at 3 years, and 76.9% at 5 years. For surviving shoulders, minimum 5-year subjective outcome data were available for 28 of 32 (87.5%) shoulders at a mean of 5.7 years (range, 5-8 years). The mean (±SD) ASES score was 84.5 ± 17, the mean SANE score was 82 ± 18, the mean QuickDASH score was 15 ± 13, the mean SF-12 PCS score was 51.0 ± 9.1, and median patient satisfaction was 9 of a possible 10 points. Conclusion: This study demonstrates significant improvements in midterm clinical outcomes and high patient satisfaction after the arthroscopic CAM procedure for GHOA, with a 76.9% survivorship rate at a minimum of 5 years postoperatively. For patients looking for an alternative to TSA, the CAM procedure can provide reasonable outcomes and should be considered an effective procedure in appropriately selected, young active patients. Further studies are warranted to evaluate long-term outcomes and durability after this procedure.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546516656372</identifier><identifier>PMID: 27496907</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Aged ; Arthritis ; Arthroscopy ; Arthroscopy - methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteoarthritis - surgery ; Pain Measurement ; Patient Reported Outcome Measures ; Patient Satisfaction ; Shoulder Joint - surgery ; Sports medicine ; Survival Rate ; Treatment Outcome</subject><ispartof>The American journal of sports medicine, 2016-12, Vol.44 (12), p.3206-3213</ispartof><rights>2016 The Author(s)</rights><rights>2016 The Author(s).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c248t-8c9506542ea4d8f15d915014c2b51187d17a29b2be559a5969b4bd6d2825f3053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27496907$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mitchell, Justin J.</creatorcontrib><creatorcontrib>Horan, Marilee P.</creatorcontrib><creatorcontrib>Greenspoon, Joshua A.</creatorcontrib><creatorcontrib>Menge, Travis J.</creatorcontrib><creatorcontrib>Tahal, Dimitri S.</creatorcontrib><creatorcontrib>Millett, Peter J.</creatorcontrib><title>Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 5-Year Follow-up</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background: There are little data on midterm outcomes after the arthroscopic management of glenohumeral osteoarthritis (GHOA) in young active patients. Purpose: To report outcomes and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at a minimum of 5 years postoperatively. Study Design: Case series; Level of evidence, 4. Methods: The CAM procedure was performed on a consecutive series of 46 patients (49 shoulders) with advanced GHOA who met criteria for shoulder arthroplasty but instead opted for a joint-preserving, arthroscopic surgical option. The procedure included glenohumeral chondroplasty, capsular release, synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture, and biceps tenodesis. Outcome measures included the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form–12 (SF-12) Physical Component Summary (PCS), visual analog scale for pain, and satisfaction scores. Kaplan-Meier survivorship analysis was performed with failure defined as progression to total shoulder arthroplasty (TSA). Results: Forty-six consecutive patients (49 shoulders) who underwent a CAM procedure at a minimum of 5 years from surgery were included. Two patients were excluded for refusing to participate before study initiation. The mean age at surgery was 52 years (range, 27-68 years) in 15 women and 29 men. All patients were recreational athletes with 7 former collegiate or professional athletes. Twelve shoulders (26%) progressed to TSA at a mean of 2.6 years (range, 0.5-8.2 years). For survivorship analysis, the status of the shoulder (preservation of the native joint or progression to TSA) at a minimum of 5 years was known for 45 of 47 (96%) shoulders. Survivorship was 95.6% at 1 year, 86.7% at 3 years, and 76.9% at 5 years. For surviving shoulders, minimum 5-year subjective outcome data were available for 28 of 32 (87.5%) shoulders at a mean of 5.7 years (range, 5-8 years). The mean (±SD) ASES score was 84.5 ± 17, the mean SANE score was 82 ± 18, the mean QuickDASH score was 15 ± 13, the mean SF-12 PCS score was 51.0 ± 9.1, and median patient satisfaction was 9 of a possible 10 points. Conclusion: This study demonstrates significant improvements in midterm clinical outcomes and high patient satisfaction after the arthroscopic CAM procedure for GHOA, with a 76.9% survivorship rate at a minimum of 5 years postoperatively. For patients looking for an alternative to TSA, the CAM procedure can provide reasonable outcomes and should be considered an effective procedure in appropriately selected, young active patients. Further studies are warranted to evaluate long-term outcomes and durability after this procedure.</description><subject>Adult</subject><subject>Aged</subject><subject>Arthritis</subject><subject>Arthroscopy</subject><subject>Arthroscopy - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Osteoarthritis - surgery</subject><subject>Pain Measurement</subject><subject>Patient Reported Outcome Measures</subject><subject>Patient Satisfaction</subject><subject>Shoulder Joint - surgery</subject><subject>Sports medicine</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp1kc1P3DAQxa0KVJZt7z0hS1x6CfhrnOS4WrUUCbQI2nPkJBPWKImD7azU_77eLq0QEqc5zO-9-XiEfOHsgvM8v2RSS1AauNagZS4-kAUHEJmUGo7IYt_O9v0TchrCE2OM57r4SE5ErkpdsnxB5ofZ7-zO-bC1EzVjS-9MtDjG7B4n5yO2dDPHxg0Y6KqL6OnaDZPHLY7B7pCufNx6Fxo32YbemtE84pDU1HX0qsfRbecBvenpJkR0Zg_baMMnctyZPuDnl7okv75_-7n-kd1srq7Xq5usEaqIWdGUwDQogUa1RcehLTkwrhpRA-dF3vLciLIWNQKUBtJJtapb3YpCQCcZyCX5evCdvHueMcRqsKHBvjcjujlUvFAgQJZKJPT8DfrkZj-m7f5SMoGqTBQ7UE06OnjsqsnbwfjfFWfVPpLqbSRJcvZiPNcDtv8F_zJIQHYAQnreq6nvGf4BGXaUFQ</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Mitchell, Justin J.</creator><creator>Horan, Marilee P.</creator><creator>Greenspoon, Joshua A.</creator><creator>Menge, Travis J.</creator><creator>Tahal, Dimitri S.</creator><creator>Millett, Peter J.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>201612</creationdate><title>Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis</title><author>Mitchell, Justin J. ; Horan, Marilee P. ; Greenspoon, Joshua A. ; Menge, Travis J. ; Tahal, Dimitri S. ; Millett, Peter J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c248t-8c9506542ea4d8f15d915014c2b51187d17a29b2be559a5969b4bd6d2825f3053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Arthritis</topic><topic>Arthroscopy</topic><topic>Arthroscopy - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Osteoarthritis - surgery</topic><topic>Pain Measurement</topic><topic>Patient Reported Outcome Measures</topic><topic>Patient Satisfaction</topic><topic>Shoulder Joint - surgery</topic><topic>Sports medicine</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mitchell, Justin J.</creatorcontrib><creatorcontrib>Horan, Marilee P.</creatorcontrib><creatorcontrib>Greenspoon, Joshua A.</creatorcontrib><creatorcontrib>Menge, Travis J.</creatorcontrib><creatorcontrib>Tahal, Dimitri S.</creatorcontrib><creatorcontrib>Millett, Peter J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mitchell, Justin J.</au><au>Horan, Marilee P.</au><au>Greenspoon, Joshua A.</au><au>Menge, Travis J.</au><au>Tahal, Dimitri S.</au><au>Millett, Peter J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 5-Year Follow-up</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2016-12</date><risdate>2016</risdate><volume>44</volume><issue>12</issue><spage>3206</spage><epage>3213</epage><pages>3206-3213</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background: There are little data on midterm outcomes after the arthroscopic management of glenohumeral osteoarthritis (GHOA) in young active patients. Purpose: To report outcomes and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at a minimum of 5 years postoperatively. Study Design: Case series; Level of evidence, 4. Methods: The CAM procedure was performed on a consecutive series of 46 patients (49 shoulders) with advanced GHOA who met criteria for shoulder arthroplasty but instead opted for a joint-preserving, arthroscopic surgical option. The procedure included glenohumeral chondroplasty, capsular release, synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture, and biceps tenodesis. Outcome measures included the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form–12 (SF-12) Physical Component Summary (PCS), visual analog scale for pain, and satisfaction scores. Kaplan-Meier survivorship analysis was performed with failure defined as progression to total shoulder arthroplasty (TSA). Results: Forty-six consecutive patients (49 shoulders) who underwent a CAM procedure at a minimum of 5 years from surgery were included. Two patients were excluded for refusing to participate before study initiation. The mean age at surgery was 52 years (range, 27-68 years) in 15 women and 29 men. All patients were recreational athletes with 7 former collegiate or professional athletes. Twelve shoulders (26%) progressed to TSA at a mean of 2.6 years (range, 0.5-8.2 years). For survivorship analysis, the status of the shoulder (preservation of the native joint or progression to TSA) at a minimum of 5 years was known for 45 of 47 (96%) shoulders. Survivorship was 95.6% at 1 year, 86.7% at 3 years, and 76.9% at 5 years. For surviving shoulders, minimum 5-year subjective outcome data were available for 28 of 32 (87.5%) shoulders at a mean of 5.7 years (range, 5-8 years). The mean (±SD) ASES score was 84.5 ± 17, the mean SANE score was 82 ± 18, the mean QuickDASH score was 15 ± 13, the mean SF-12 PCS score was 51.0 ± 9.1, and median patient satisfaction was 9 of a possible 10 points. Conclusion: This study demonstrates significant improvements in midterm clinical outcomes and high patient satisfaction after the arthroscopic CAM procedure for GHOA, with a 76.9% survivorship rate at a minimum of 5 years postoperatively. For patients looking for an alternative to TSA, the CAM procedure can provide reasonable outcomes and should be considered an effective procedure in appropriately selected, young active patients. Further studies are warranted to evaluate long-term outcomes and durability after this procedure.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>27496907</pmid><doi>10.1177/0363546516656372</doi><tpages>8</tpages></addata></record>
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source Sage Journals Online; SPORTDiscus with Full Text
subjects Adult
Aged
Arthritis
Arthroscopy
Arthroscopy - methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Osteoarthritis - surgery
Pain Measurement
Patient Reported Outcome Measures
Patient Satisfaction
Shoulder Joint - surgery
Sports medicine
Survival Rate
Treatment Outcome
title Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 5-Year Follow-up
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