What is the role of arthroscopic debridement for glenohumeral arthritis? A critical examination of the literature

Purpose: To critically examine the outcomes of arthroscopic debridement for glenohumeral arthritis and to perform an evidence-based synthesis of the available literature. Methods: A systematic review of the literature was performed by a search of electronic databases. Two reviewers independently assessed the methodologic quality and extracted relevant data from each included study. When outcomes data were similar between studies, data were pooled for the purposes of generating summary outcomes through the use of frequency-weighted values. Results: Five studies were included after fulfilling all inclusion and exclusion criteria. At a frequency-weighted mean follow-up of 34.8 months, 212 patients (range, 19 to 71 patients) with a frequency-weighted mean age of 49.2 years were available for follow-up evaluation. In general, patients had significant improvement in motion and functional outcomes. Thirteen percent of patients underwent conversion to a shoulder arthroplasty. The influence of specific patient demographics, degree of glenohumeral stiffness, and arthritis severity on functional outcome and treatment failure could not be determined. Conclusions: This systematic review shows that arthroscopic debridement for glenohumeral arthritis lacks high-quality evidence to support its routine use. Level IV-type evidence would suggest improvement in pain relief and patient satisfaction in the short-term. Future studies should comprehensively define patient characteristics, trend results over time, and attempt to find associations between patient variables and outcome. Level of Evidence: Level IV, systematic review of Level IV studies.