Debridement (removing degenerative tissue and arthroplasty
(joint replacement)) are the two operative procedures used to treat
glenohumeral arthritis. Debridement can be done either with an arthroscope
or through a larger incision. Arthroplasty requires an incision.
Debridement:
Rids the joint of loose cartilage flaps
Removes enzymes that cause inflammation
Cleans out loose bodies and osteophytes
May also include the release of a tight, restrictive joint capsule
In debridement, the physician smoothes the damaged articular cartilage to ease the pain and symptoms associated with the mechanical effects of arthritis (locking, catching, and popping). Debridement may provide temporary pain relief, but does not stop cartilage destruction, which is the primary cause of arthritis pain.
Debridement is usually recommended for patients who are not good candidates for shoulder replacement such as:
Young people
Those with a history of joint infection
Those with loose bodies and small, painful cartilage defects
Those with mild to moderate joint destruction not severe enough to require shoulder replacement
Both open and arthroscopic debridement techniques have advantages. The arthroscopic procedure has the advantage of being minimally invasive, while open debridement provides greater access to the joint and may permit more complete removal of osteophytes and soft tissue contractures (scar tissue).
