Articular Cartilage Injuries of the Glenohumeral Joint: Diagnosis, Imaging, and Management

Abstract

Injuries to the articular cartilage of the glenohumeral joint represent a challenge to the orthopaedic surgeon from diagnosis to management. The etiologies of such injuries are numerous, and despite exhaustive physical examination and modern imaging techniques, their diagnosis remains difficult and they are often incidental findings made in the course of treating a concomitant injury. Following their diagnosis, the options for treating injuries to the glenohumeral cartilage are multiple, ranging from conservative treatment to surgery. Their management must be tailored to the type of lesion and the individual patient in terms of the patient's age, activity level, and expectations. Although arthroplasty has produced good results in the treatment of advanced glenohumeral osteoarthritis in elderly patients, its clinical outcomes are less predictable in the younger and more active population, and the risk of such complications as the early loosening of implants is higher in this population. New technologies and mini-invasive surgical techniques have recently provided alternative treatments for this younger patient population. Additionally, the literature has described many restorative and reconstructive techniques for lesions of the glenohumeral cartilage, in all of which the goal is to delay the need for arthroplasty. This article describes the challenges associated with the diagnosis and management of injuries to the glenohumeral articular cartilage, and emphasizes techniques for preserving the shoulder joint in young patients with active demands on this joint.

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