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American Association for Hand Surgery

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Cadaveric Evaluation of the Feasibility of Glenohumeral Joint Denervation
Amr M Aly/Amr, MD, Ain Shams University, Cairo, Egypt

Introduction:
Young active individuals with glenohumeral joint osteoarthritis (GHJ OA) pose a unique management challenge. Although shoulder arthroplasty is considered the defnitive treatment of GHJ OA, it is not an ideal procedure for the young patient. Young patients have a significantly higher incidence of component failure and inferior patient-reported outcomes than older ones. The purpose of our study is to assess the feasibility of total shoulder denervation through two proposed incisions.
Materials and Methods:
Total shoulder denervation was performed through an extended delta-pectoral approach and a transverse dorsal approach at the spine of the scapula. The study involved six cadavers. Course and number of articular branches from the lateral pectoral, axillary and supra-scapular nerve were documented.
Results:
All shoulder joint articular branches were accessible through the proposed anterior and posterior approaches. The articular branch of the lateral pectoral nerve and supra scapular nerve were present in all the specimen. Axillary nerve articular branches were variable in number but when present anteriorly were proximal to the deltoid muscular branches and posteriorly proximal to the muscular branches to the teres minor
Conclusion:
Total glenohumeral denervation was feasible through our proposed anterior and posterior approaches. Enhanced knowledge of articular nerve branches could provide interventional targets for joint and ligament pain, with low risk of muscle weakness.


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