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Objectives and questions: Purpose of the present study was to evaluate clinical and radiologic outcomes after autologous minced cartilage implantation (MCI) for isolated, grade IV cartilage defects of the glenohumeral joint. It was hypothesized that MCI would result in reliable clinical outcomes and sufficient radiographic cartilage repair tissue quality.

Material and methods: Patients who underwent arthroscopic MCI for isolated, grade IV cartilage defects of the glenohumeral joint between 10/2021 to 08/2022 and had a minimum follow-up of two years were analyzed. Clinical evaluation included the Constant-Murley (CM) score, American Shoulder and Elbow Surgeons (ASES) score, Disability of the Arm, Shoulder and Hand (DASH) score, Simple Shoulder Value (SSV), Visual Analogue Scale (VAS) for pain, as well as assessment of range of motion and strength. Postoperative shoulder-dependent athletic ability was evaluated using the Athletic Shoulder Outcome Scoring System (ASOSS). Cartilage repair tissue morphology was assessed on 3-Tesla magnetic resonance imaging scans by three independent raters (one specialized musculoskeletal radiologist, two specialized shoulder surgeons) using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score.

Results: All eligible six patients (mean age at surgery: 27.6±7.8 years; follow-up rate 100%) were included in the study, with a mean follow-up of 2.4±0.3 years (range: 2.0–2.8 years). The focal cartilage defect was located at the glenoid in five patients and humeral head in one patient, with an average size of 2.4±1.2 cm² (range: 1.0-4.0 cm²). At final follow-up patients achieved a CM of 85.7±7.9, CM relative to the contralateral side of 94.5±4.7, ASES of 93.8±5.5, SSV of 87.5±9.4, and DASH of 6.0±5.2. The DASH sport and music subcategory was 9.4±9.5, while the DASH work subcategory was 1.0±2.6. The VAS for pain was 0.2±0.4 at rest and 1.5±0.8 during exercise. Patients demonstrated no difference in range of motion and strength compared to the contralateral side (P>0.05, respectively). With an ASOSS of 88.0±6.6 patients showed a good athletic ability. The average MOCART score was 74.4±10.0, demonstrating sufficient cartilage quality. No complications were observed and none of the patients underwent revision surgery.

Discussion and conclusion: Patients who underwent MCI for treatment of focal cartilage defects of the glenohumeral joint showed good to excellent clinical outcomes along with a sufficient radiographic cartilage repair tissue quality at a minimum follow-up of two years.