Comprehensive Post-Arthroscopic Management of a Middle-Aged Adult with Gelnohumeral Osteoarthritis: A Case Report

Authors:

Nicholas D Hagen, Thomas Olson, Peter Millett

Abstract:

A current challenge in the medical field is how to manage young and middle aged patients diagnosed with glenohumeral osteoarthritis (GHOA). In the general population, the incidence of GHOA is 5-17%. The gold standard for treating GHOA is Total Shoulder Arthroplasty (TSA), but for younger patients the hardware utilized may erode and lead to a non-functional shoulder. For this reason, only 10% of shoulder arthroplasties are performed on patients aged 55 years or younger. As a result, there is no clear management option to treat active, young and middle aged patients who present with significant arthrosis of the glenohumeral joint.

Total shoulder arthroplasty in a young population has been marked with a high percentage of unsatisfactory results. Due to the lack of success of shoulder arthroplasty on young patients, more complex arthroscopic procedures have been developed as a method to delay the more invasive arthroplasty. A new arthroscopic procedure for salvaging an arthritic glenohumeral joint has been named Comprehensive Arthroscopic Management (CAM). The CAM procedure is used to restore joint stability, decrease pain, improve range of motion, and delay the need for arthroplasty in younger, active patients. To date there are no studies on rehabilitation after a CAM procedure. Consequently, physical therapists need further information on how to treat patients who have undergone surgery using CAM techniques.

The CAM procedure for GHOA was developed by Dr. Peter Millet MD, of the Steadman Clinic in Vail, CO. The procedure involves several arthroscopic components including: A. scar tissue and chondral debridement, B. synovectomy, C. inferior humeral osteoplasty, D. capsular release, E. axillary nerve decompression, and F. tenodesis of the long head of the biceps. Previous arthroscopic procedures have not included humeral head osteoplasty or axillary nerve decompression as routine portions of an arthroscopic joint preservation procedure.

The primary purpose of this case report is to describe the course of treatment for a middle-aged woman with GHOA as well as the role that radiologic imaging played. This case report will benefit physical therapists and other medical professionals by describing the indications for the procedure and having a reference for the treatment of a patient following a CAM procedure.

For the complete study: Comprehensive Post-Arthroscopic Management of a Middle-Aged Adult with Gelnohumeral Osteoarthritis: A Case Report

Peter Millett, MD

Average rating:

39 reviews

Alexandra Thompson

Mar 23, 2024

by Alexandra Thompson on Peter Millett, MD

110%

Dr. Millett and his team did a SLAP tear repair and bicep tenodesis on my left shoulder. I use my arms as an artist, and love to swim in the ocean, surf, paddle, and telemark ski. So regaining full use of my shoulder and keeping my bicep attached was very important to me. Now, over two years later, my shoulder has the equivalent range of motion as my other arm and as before the injury, and no pain. After the first three months it felt so good and was so strong that - to my horror - I completely forgot my six-month follow-up.

Not only did Dr. Millett and his team make my arm as good as new, but having had the experience of such kindness and expertise throughout the process of surgery and recovery is like an added shoulder superpower.

Thank you Rita, Brooke, Jason, Sarah, Camille, Olivia, Dr. Millett and everyone! And see you soon when my husband comes in for his knee...

Jeff Chandler

Jan 31, 2022

by Jeff Chandler on Peter Millett, MD

Flawless procedure, Easy recovery

Dr. Millet's repaired my knee and tibia, following a botched operation by a different surgeon. That procedure was virtually pain free and I was weight bearing within a few days. That was 18 years ago and the knee is still strong. A few years after the knee incident, Dr Millet repaired my shoulder. My insurance company approved me for 3 months of disability following that surgery. I was off pain medication in 2 days and had 90% range of motion within a week. I withdrew my disability claim and returned to work within two weeks of surgery. I’m not a famous athlete—just a regular guy. Nonetheless, I was treated like an NFL at the Steadman clinic. Most notable was the time for recovery. Other surgeons perform their hour-long task in the OR and don’t involve themselves in the other functions. Peter and his team manages the entire process from diagnosis, anesthesia, nursing care, and therapy. He takes a holistic approach to patient care and doesn’t skip any steps.

Jenn West

Jul 2, 2021

by Jenn West on Peter Millett, MD

Saved My Life

I went to Dr. Millett after 7 knee surgeries (6 on my right and 1 on my left) and had seen 11 different surgeons who all refused to remove femur metal from my right leg. I am highly allergic to metal and the chronic pain was leaving me bedridden for 3.5wks out of a month. He personally wrote me back on my inquiry, listened to my concerns, scheduled my surgery within a week (due to insurance issues) and personally followed up with my recovery. The level of patient care from Dr. Millett and his ENTIRE team is above any care I have ever received in my 20 years of dealing with orthopedic surgeons. There are not enough words to describe the level of care, dedication and professionalism you receive from Dr. Millett and his staff.
My only disappointment is that I did not find him sooner!!!

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Comprehensive Post-Arthroscopic Management of a Middle-Aged Adult with Gelnohumeral Osteoarthritis: A Case Report

Authors:

Abstract:

About the Author: Peter Millett, MD