Arthroscopically assisted shoulder arthrodesis: is it an effective technique?

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Shoulder Joint Reconstruction

Background:

• Glenohumeral arthrodesis aims to fuse the shoulder joint, often indicated for severe arthritis or instability.
• Traditional open arthrodesis can involve significant morbidity.
• Advancements in arthroscopic techniques offer potential for less invasive joint fusion.

Purpose of the Study:

• To compare clinical and radiographic outcomes of open versus mini-open arthroscopic glenohumeral arthrodesis.
• To evaluate the efficacy and safety of a minimally invasive approach for shoulder fusion.

Main Methods:

• A case series comparing 12 patients undergoing arthroscopically assisted mini-open glenohumeral arthrodesis with a historical open group.
• Arthroscopic cartilage removal followed by percutaneous K-wire and screw fixation, with a mini-open posterior approach for screw finalization.
• Immobilization for 6 weeks, with radiographic follow-up at 2, 6, 12, and 24 months.

Main Results:

• 100% fusion achieved in the arthroscopic group at 2-year follow-up.
• Similar infection rates (2 per group) and patient satisfaction between groups.
• Fewer revision surgeries required in the arthroscopic group (2 early bone grafts) compared to the open group (4 additional grafts, 1 humeral fracture).

Conclusions:

• Arthroscopically assisted mini-open glenohumeral arthrodesis is a viable alternative to open arthrodesis.
• The technique provides comparable fusion and complication rates with a less invasive approach.
• Minimally invasive arthrodesis may reduce the need for subsequent surgical interventions.