It is established that glenohumeral arthrosis typically manifests after the sixth decade of life. Younger patients, however, are also occasionally afflicted, and many of these patients maintain demanding lifestyles. Concerns regarding polyethylene glenoid wear, component loosening, functional loss, and the potential need for multiple revisions over the patient’s lifetime potentially make young, high-demand patients poor candidates for shoulder arthroplasty. Prior reports indicate that arthroscopic debridement can yield pain and functional improvements in this patient population.
Previous studies have suggested that outcomes of arthroscopic debridement are less effective when a large inferior osteophyte is present. We speculate that inferior humeral osteophytes may limit abduction by tensioning the axillary pouch and are capable of compressing the axillary nerve. As evidenced by quadrilateral space syndrome, patients with axillary nerve compression often describe posterior shoulder pain, weakness, and decreased athletic performance. Similarly, patients with glenohumeral arthrosis frequently report posterior shoulder pain and often exhibit large inferior humeral osteophytes in close proximity to the axillary nerve. Data from our laboratory have shown that these osteophytes are capable of encroaching on the axillary nerve, changing the course of the nerve, and potentially affecting axillary nerve function (P.J.M., unpublished data, May 2010). Therefore we believe that removal of the large inferior humeral osteophytes could decompress the axillary nerve and alleviate pain in patients with glenohumeral arthrosis.