Clinical Outcomes after Microfracture of the Glenohumeral Joint

Abstract

Background Microfracture is an effective surgical treatment for isolated, full-thickness cartilage defects with current data focused on applications in the knee. No studies describing clinical outcomes of patients who have undergone microfracture in the shoulder joint have been reported. Hypothesis Treatment of glenohumeral joint articular defects using microfracture would demonstrate similar short-term clinical outcomes when compared with other joints. Study Design Case series; Level of evidence, 4. Methods From March 2001 to August 2007, 16 patients (17 shoulders) who underwent arthroscopic microfracture of the humeral head and/or glenoid surface were retrospectively reviewed. All patients were examined by an independent, blinded examiner and completed surveys containing the Simple Shoulder Test (SST), American Shoulder and Elbow Score (ASES), and visual analog scale (VAS). Results Two patients were lost to follow-up, for a follow-up rate of 88%. Three patients went on to subsequent shoulder surgery and were considered to have failed results. The mean age was 37.0 years (range, 18-55 years) with an average follow-up of 27.8 months (range, 12.1-89.2 months). The average size of humeral and glenoid defects was 5.07 cm2 (range, 1.0-7.84 cm2) and 1.66 cm2 (range, 0.4-3.75 cm2), respectively. There was a statistically significant decrease from 5.6 ± 1.7 to 1.9 ± 1.4 (P < .01) in VAS after surgery as well as statistically significant improvements (P < .01) in SST (5.7 ± 2.1 to 10.3 ± 1.3) and ASES (44.3 ± 15.3 to 86.3 ± 10.5). Twelve (92.3%) patients claimed they would have the procedure again. Conclusion Microfracture of the glenohumeral joint provides a significant improvement in pain relief and shoulder function in patients with isolated, full-thickness chondral injuries. Longer term studies are required to determine if similar results are maintained over time.