Long-term clinical and radiological outcomes following arthroscopic microfracture of the glenohumeral joint for chondral defects

Sam Hookway; Angela Alder-Price; Stephen D Gill; Andrew Mattin; Richard S Page

doi:10.1016/j.jseint.2023.06.022

Long-term clinical and radiological outcomes following arthroscopic microfracture of the glenohumeral joint for chondral defects

JSES Int. 2023 Jul 22;7(6):2440-2444. doi: 10.1016/j.jseint.2023.06.022. eCollection 2023 Nov.

Authors

Sam Hookway¹, Angela Alder-Price^{1

2}, Stephen D Gill^{1

3

4}, Andrew Mattin⁵, Richard S Page^{1

3

4}

Affiliations

¹ Department of Orthopaedics, University Hospital Geelong, VIC, Australia.
² The University of Adelaide, School of Medicine, SA, Australia.
³ School of Medicine, Deakin University, Geelong, VIC, Australia.
⁴ Department of Surgery, Barwon Centre for Orthopaedic Research & Education, St John of God Hospital Geelong, VIC, Australia.
⁵ Department of Surgery, Fiona Stanley Hospital, Perth, WA, Australia.

Abstract

Background: The primary aim of this study was to evaluate mid- and long-term outcomes following microfracture in patients with glenohumeral chondral lesions.

Methods: This prospective cohort study assessed patients with shoulder pain who were treated with arthroscopic microfracture for full-thickness chondral lesions of the glenohumeral joint. Outcomes included the Simple Shoulder Test at baseline, mid-term (approximately 1 year) and long-term (approximately 10 years), and the Oxford Shoulder Score, shoulder pain (0-10 numerical scale) and radiological assessment using a modified Samilson & Prieto score at long-term follow-up. Data were analyzed with paired t-tests and Wilcoxon's signed rank tests, which were considered significant if P < .05.

Results: Twenty-five patients with a mean age of 52.7 ± 12.1 were enrolled. The mean Simple Shoulder Test score improved from baseline to 1 year (6.7 ± 2.5 to 11.0 ± 1.4, P < .001), which was maintained at long-term follow-up (10.3 ± 2.1, P < .001). Additionally, at long-term follow-up, Oxford Shoulder Score and Verbal Pain Score scores were 43 ± 4.8 and 1.1 ± 1.5, respectively while median modified Samilson & Prieto scores increased from 1 preoperatively to 2 at 10 years (P < .001).

Conclusion: Patients undergoing microfracture for full-thickness chondral lesions of the glenohumeral joint reported substantial improvements in shoulder pain and function at 1 and 10 years, despite progressive radiological degeneration.

Keywords: Chondral lesion; Glenohumeral joint; Long-term; Microfracture; Osteoarthritis; Shoulder.