This is a Level 4 case series of the comprehensive arthroscopic management (CAM) procedure for advanced glenohumeral osteoarthritis in young active patients. All patients met criteria for shoulder arthroplasty but chose a joint-preserving arthroscopic option instead. The study asks whether the early 2-year benefits hold up at a minimum 5-year follow-up and which patients progress to total shoulder arthroplasty.
When a young active patient has advanced GHOA but wants to avoid a shoulder replacement, the CAM procedure is a reasonable option, and this paper tells you who it works for. The headline number is 76.9% native-joint survivorship at 5 years, with pain and function gains holding steady from the 2-year mark, so the early benefit is not just patients coping with a bad result.
Patient selection drives everything. Before offering CAM, get a true AP or Grashey view and a glenoid morphology assessment: a Walch B2 or C glenoid or joint space under 2 mm predicts conversion to TSA and should push you toward arthroplasty instead.
Remember the exclusions: irreparable rotator cuff tears and bipolar humeral head flattening are contraindications. Counsel patients that roughly 1 in 4 will still convert to TSA, most within the first few years.
This is a Level 4 case series of the comprehensive arthroscopic management (CAM) procedure for advanced glenohumeral osteoarthritis in young active patients. All patients met criteria for shoulder arthroplasty but chose a joint-preserving arthroscopic option instead. The study asks whether the early 2-year benefits hold up at a minimum 5-year follow-up and which patients progress to total shoulder arthroplasty.
When a young active patient has advanced GHOA but wants to avoid a shoulder replacement, the CAM procedure is a reasonable option, and this paper tells you who it works for. The headline number is 76.9% native-joint survivorship at 5 years, with pain and function gains holding steady from the 2-year mark, so the early benefit is not just patients coping with a bad result.
Patient selection drives everything. Before offering CAM, get a true AP or Grashey view and a glenoid morphology assessment: a Walch B2 or C glenoid or joint space under 2 mm predicts conversion to TSA and should push you toward arthroplasty instead.
Remember the exclusions: irreparable rotator cuff tears and bipolar humeral head flattening are contraindications. Counsel patients that roughly 1 in 4 will still convert to TSA, most within the first few years.