Treatment of Articular Cartilage Injuries in the Glenohumeral Joint

Background: Articular cartilage injuries in the glenohumeral joint present significant clinical challenges that can lead to pain and functional impairment. These injuries can arise from various causes, including acute trauma, chronic overuse, or degenerative changes. The highly mobile glenohumeral joint is particularly susceptible to such injuries, often manifesting as pain, swelling, and mechanical symptoms such as clicking or grinding. Understanding the nature and extent of cartilage damage is crucial, as articular cartilage has limited healing capacity due to its avascular nature. Early diagnosis and appropriate treatment are essential to prevent the progression of arthritis and maintain joint function. Methods: This study examines both conservative and surgical treatment options for articular cartilage injuries in the shoulder. Initial management typically involves non-surgical methods such as activity modification, physical therapy focused on strengthening the surrounding muscles, and the use of anti-inflammatory medications. If conservative treatments fail, surgical options are considered. Various surgical techniques, including microfracture, autologous chondrocyte implantation (ACI), and osteochondral autograft/allograft (OATS), are also discussed. The goal of each method is to restore cartilage integrity and improve joint function based on the size and location of the defect. Results: Findings suggest that conservative management is effective for many patients with focal cartilage injuries, especially in younger individuals. Non-surgical approaches usually involve a combination of rest, physical therapy aimed at improving strength and range of motion, and pharmacological interventions such as NSAIDs or corticosteroid injections. However, for patients who do not experience relief from these measures, surgical interventions may be necessary. Techniques like microfracture, which stimulates cartilage repair by creating small holes in the underlying bone, show promise for enhancing recovery. Additionally, ACI offers an advanced solution by allowing the growth of new cartilage cells from a biopsy taken from the patient’s knee. The choice of surgical intervention is influenced by factors such as the size of the defect, the patient’s age, activity level, and related shoulder pathology. Conclusion: In conclusion, the treatment of articular cartilage injuries in the glenohumeral joint requires an appropriate approach based on the individual characteristics of the patient and the nature of the injury. While many patients benefit from conservative management strategies, those with persistent symptoms may require surgical intervention to restore function and alleviate pain. Furthermore, the evolution of surgical techniques offers various options that can effectively address different types of cartilage defects. Ongoing research into these methods will continue to improve outcomes for patients suffering from these challenging injuries.

کلیدواژه ها:

Articular cartilage injury ، glenohumeral joint ، non-surgical treatment ، surgical intervention ، microfracture