Arthroscopic Biologic Resurfacing for Shoulder Arthritis
Shoulder replacement has a successful track record for the treatment of shoulder arthritis. Survival rates are very good for these implants however, the component used to replace the shoulder joint are at risk of loosening or wearing out with prolonged/excessive use. Dr. Christopher Lenarz therefore tries to avoid these complications through the use of less invasive arthroscopic procedures in appropriately selected patients. These procedures are performed to salvage the joint present rather than replace it. Dr. Christopher Lenarz may perform an outpatient arthroscopic procedure for the arthritic shoulder.
The arthroscopic procedure can be done at the hospital or an outpatient surgical center. Through very small incisions, Dr. Christopher Lenarz inserts small instrument into the shoulder including a camera. The entire shoulder is inspected under direct visualization with this camera and any damage that may not have been noted on an MRI will be addressed appropriately.
In the case of advanced degenerative change (arthritis), Dr. Christopher Lenarz can performs arthroscopic resurfacing of the joint using osteochondral allografts. This procedure was first performed by Dr. Christopher Lenarz and his mentor during fellowship. This procedure offers a biologic solution to arthritis as a majority of the damaged cartilage is replaced with new donor cartilage. The advantages of this procedure are that it is done all arthroscopically and there is no significant bone loss associated with performing this surgery. This is especially important in the young active patient where a standard total shoulder arthroplasty is at high risk of early failure. This is secondary to the increased stresses and use that a “younger” patient normally places on their shoulder. This can lead to early loosening of the implants and failure.
These techniques have been used with good success in the knee for decades. The first arthroscopic resurfacing of the shoulder was performed by Dr. Christopher Lenarz and his mentor during fellowship in 2010. To perform the procedure, the capsular contractures of the shoulder must first be released to loosen the shoulder. Regions of the surface of the ball and cup are then removed arthroscopically to create a socket for placement of the new, healthy cadaver bone and cartilage.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Once the block wears off, mobilization of the arm may begin. The dressing may be removed and you may shower the day following surgery. Please do NOT scrub the incision but allow water to wash over them. The arm may be removed from the sling and moved to tolerance. Pushing, pulling and lifting as well as throwing should be avoided until the grafts have healed but the arm may be moved in all directions. Please be sure to call with any questions.