Comprehensive Arthroscopic Management Procedure | Shoulder Osteoarthritis Treatment

This video discusses the Comprehensive Arthroscopic Management (CAM) Procedure as a shoulder osteoarthritis treatment. The CAM procedure is used in young or active patients with high functional demands who have shoulder arthritis or shoulder osteoarthritis who wish to delay a shoulder replacement.

The procedure begins with the patient seated in the beach chair position. Initially, the gelnohumeral joint undergoes extensive debridement to help facilitate visualization and diagnostic arthroscopy. This is accomplished with a shaver and radio frequency device.

Biceps tenotomy is performed in most cases, when the biceps demonstrates subluxation or tearing. Attention is then turned to the inferior humeral head osteophyte resection. The axillary pouch is then cleared using a shaver, but the capsular is not typically released until after osteoplasty is complete. Osteoplasty is then performed by resecting the inferior humeral head osteophyte. Often times, loose bodies are encountered and must be removed.

Next, an inferior capsulotomy is performed. Extreme caution must be used to avoid injury to the axillary nerve. Then, an anterior and posterior capsular release is performed. The subcoracoid space is inspected and debrided. Subacromial decompression is first performed by entering the subacromial space and then performing a bursectomy. In cases where the biceps tendon is released arthroscopically, an open subpectoral biceps tenodesis is performed following all arthroscopic procedures.

The post-operative rehabilitation involves immediate range of motion along with passive and stretching movements. At 6 weeks post-op functional strengthening begins and at the 3 month mark, patients can return to activities.