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Review
. 2023 Dec;15(6):580-592.
doi: 10.1177/17585732221142610. Epub 2022 Dec 14.

Surgical treatment options for articular cartilage defects of the glenohumeral joint: A systematic review

Danielle Dagher  1 , Asher Selznick  2 , Carlos Prada  3 , Yasser Al Shehab  3 , Timothy Leroux  4 , Moin Khan  3   5
Affiliations
Review

Surgical treatment options for articular cartilage defects of the glenohumeral joint: A systematic review

Danielle Dagher et al. Shoulder Elbow. 2023 Dec.

Abstract

Background: Many joint-preserving surgical interventions for cartilage defects of the knee have been adapted for use in the shoulder; however, there still exists no clear consensus for treatment. Thus, the purpose of this systematic review was to evaluate the outcomes of different interventions in patients with focal chondral lesions of the glenohumeral joint.

Methods: A literature search was conducted using PubMed, Embase, and Medline. Patients who underwent a joint-preserving surgical procedure to treat a focal chondral defect of the glenoid, humeral head or both were included. Patients treated for diffuse cartilage defects or with shoulder arthroplasty were excluded.

Results: Ten studies were included, with follow-up data available for 194 shoulders. Eight joint-preserving procedures were evaluated, with microfracture being the most common. One study evaluating microfracture reported significant improvements in patient-reported outcomes at short-term and long-term follow-up compared to preoperative scores. Across all studies, 32 patients underwent subsequent shoulder surgery, with 22 being arthroplasties.

Conclusions: We found improvements in patient-reported and functional outcomes across all studies. Although joint-preserving procedures have shown reasonable outcomes for focal chondral defects of the glenohumeral joint, long-term outcomes remain unknown, and the progression of osteoarthritis remains a concern. Higher quality evidence is required to make definitive recommendations.

Level of evidence: IV.

Keywords: Glenohumeral; cartilage; chondral defect; joint-preserving; surgery.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA study flow diagram.
See this image and copyright information in PMC

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