Arthroscopic Biologic Total Shoulder Resurfacing

The shoulder joint is formed by the upper arm bone and a cup-like depression on the shoulder blade. Smooth cartilage lines the joint surfaces, but degeneration or damage can occur from various factors, leading to pain and loss of motion.

Biological shoulder joint resurfacing is recommended for young, active individuals under 50 years old with flexible arthritis and large areas of defects that have not been effectively treated with conservative methods. The procedure is minimally invasive, performed arthroscopically with the patient under general anesthesia in an outpatient setting. After removing the diseased tissue, a guide pin is drilled to reach the defects in the articular surface. Healthy osteochondral grafts from a deceased donor are then prepared and introduced into the defects, guided by the arthroscope. The allografts are held in place with chondral darts and checked for accuracy before closing the incisions.

The advantages of biological resurfacing include avoiding implant failure, quick recovery, reduced pain and trauma, decreased risk of infection, and use of natural bone grafts for normal anatomical structure and function of the joint. Disadvantages include the potential for long-term failure and eventual replacement surgery. Risks and complications may include bleeding, infection, blood clots, graft failure, shoulder stiffness or weakness, persistent pain, and damage to adjacent nerves or blood vessels.

Post-operative care involves a week of wearing a sling followed by passive assisted range of motion exercises. Active range of motion exercises and strengthening exercises begin at 2 weeks and 6 weeks post-op, respectively.