Background
Symptomatic focal chondral lesions in young and physically active patients and the ever increasing demand to preserve function up until old age, make treatment challenging. These conditions require innovations in joint-preserving treatment options and total glenohumeral joint replacement.
Material and methods
The aim of this article is to illustrate arthroscopic partial humeral head resurfacing for focal chondral lesions and innovations of reverse total shoulder arthroplasty. An illustration of the background of arthroscopic humeral head resurfacing and the use of anatomical shaftless shoulder prostheses as well as reverse total shoulder arthroplasty with an inclination angel of 135° is given. The indications, surgical technique as well as clinical and radiological results are presented.
Results
Arthroscopic partial humeral head resurfacing provided significant improvement of clinical outcome at 5‑year follow-up and the revision rate was below 20%. Shaftless anatomical prostheses provided a significant reduction in operation time and better anatomical conditions in revision surgery. Anatomical shaft angle and lateralization of the glenosphere provided a minimalization of scapular notching and improvement of rotation in reverse shoulder arthroplasty.
Conclusion
Innovations in glenohumeral joint-preserving and also in anatomical and reverse total shoulder arthroplasty showed promising results with an increase of function and reduction of postoperative pain. Arthroscopic humeral head resurfacing represents a treatment option for humeral chondral defects without biomechanical alterations and structural damage.