Contribution of arthroscopy in the treatment of anterior glenoid rim fractures: a comparison with open surgery.

BACKGROUND: This study assessed the clinical and radiologic outcomes of Ideberg type IA glenoid fractures treated using conventional open surgery compared with those treated with arthroscopic surgery. MATERIALS AND METHODS: This was a retrospective, multicenter study of anterior glenoid rim fractures (Ideberg IA) treated with conventional open surgery (group O) or arthroscopic surgery (group A). Included were 56 patients: 10 in group O and 46 in group A. The patients were reviewed after a minimum of 12 months of follow-up. The Constant score was used as an objective clinical outcome. Radiographs were reviewed to assess the quality of the postoperative reduction, fracture healing, complications, and whether osteoarthritis was present at the last follow-up. RESULTS: At a mean follow-up of 30 months (range, 12-115 months), there was no significant difference between the groups based on the Constant Score (group O: 74 points; group A: 84 points, P = .07). None of the shoulders showed signs of instability. Conversely, the rate of postoperative complications was higher in group O than in group A (30% vs. 4%; P = .03). Glenohumeral osteoarthritis was found in 10% of group O patients and 18% of group A patients (P = .65). CONCLUSIONS: This study shows that anterior glenoid rim fractures have similar functional outcomes, whether treated using conventional open surgery or arthroscopic surgery. Arthroscopic surgery appears to reduce the complication and reoperation rate.

Arthroscopic treatment of non-homogeneous calcifying tendinitis of the rotator cuff.

The purpose of this study is to investigate the clinical outcome of arthroscopic treatment for patients with non-homogeneous infiltrated calcifying tendinitis of the rotator cuff (type III), and to assess the optimal method for this arthroscopic treatment. We retrospectively reviewed the charts of 81 patients who underwent arthroscopic treatment for non-homogeneous infiltrated calcifying tendinitis of the rotator cuff (type III). Patients were divided into two groups: Group A (n = 31) consisted of patients who underwent excision of calcification, and Group B comprised patients who underwent acromioplasty alone (n = 50). The clinical outcome of treatment was assessed using Constant-Murley score. Twenty-three of the 81 patients were males and 58 were females. The mean duration of symptoms from onset to the first clinic visit was 3.88 years (SD ± 3.06 years). The right side was involved in 47 patients, the left side in 34 patients, and none had bilateral involvement. Patients from Group B had higher 16 improvement of their Constant-Murley score (from 48.96 to 88.06) when 17 compared to group A (from 45.39 to 67.23). Treatment of type III calcifying tendinitis is different than type I and II. Subacromial decompression may be considered in all patients suffering from type III non-homogeneous infiltrated calcifying tendinitis of the shoulder.