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肩关节关节炎

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Shoulder arthritis causes pain, stiffness, and reduced range of motion — diagnosis and treatment options explored.

Updated Jun 2026
一幅手绘插图，展示了一个磨损的骨关节炎性盂肱关节，骨与骨直接接触。
X线片上的肩关节关节炎：缓冲盂肱关节的软骨已磨损殆尽，关节间隙变窄，关节盂周围形成了骨赘。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

肩关节关节炎是一种常见的疾病。它会导致关节表面的磨损和损伤。您可能会注意到，随着年龄增长，疼痛会加剧，X 光片上也会出现更明显的变化。疼痛通常逐渐开始。在某些情况下，病情会迅速恶化，尤其是在老年女性中。

您可能会感到肩关节深处疼痛。这种疼痛通常在夜间加重。在您使用手臂后或刚醒来时，疼痛也可能加剧。简单的日常任务会变得困难。您可能难以将手伸到背后扣上胸罩。塞衬衫可能会感到别扭或疼痛。将物体举过头顶可能会引发剧烈的不适。

您的外科医生会检查特定的关节磨损模式。例如，您的上臂骨（肱骨）头部可能会在关节盂中向后移位。这被称为后方半脱位。随着时间的推移，这种移位可能会改变关节的磨损方式。大约 20% 具有这种模式的肩关节在十年内会发展为偏心性磨损模式。您的外科医生会寻找这些迹象以了解您的具体情况。

您可能会怀疑感染是否导致了您的疼痛。您的外科医生可能会使用先进的影像学检查，如特殊的 PET/CT 扫描，来区分感染和标准关节炎。这有助于确保您获得正确的治疗。

虽然管理策略在不断演变，尤其是对于年轻患者，但如果您非常活跃，植入物的耐久性仍然是一个令人担忧的问题。您的外科医生会与您讨论最佳方案。如果您的肩袖肌腱健康，解剖型全肩关节置换术通常是标准选择。反式全肩关节置换术是另一种选择，特别是当肩袖受损或情况复杂时。这两种方法都旨在减轻疼痛并改善功能。

如果您的关节炎在 X 光片上表现为轻度，与患有严重关节炎的患者相比，您在接受解剖型全肩关节置换术后没有显著改善的可能性高出约 7 倍。这对于您的决策至关重要。您的外科医生将帮助您将这些因素与您的日常需求和活动水平进行权衡。

实际发生了什么

肩关节关节炎是一种常见的退行性疾病，表现为骨端表面的光滑覆盖层发生磨损。这种覆盖层称为软骨，起到缓冲作用。当软骨变薄或消失时，骨骼之间会相互摩擦，从而导致疼痛和僵硬。包裹肩关节的关节囊也可能发生挛缩。

在许多情况下，肩袖肌腱仍然完整。这些肌腱如同绳索，有助于抬起手臂。当肩袖功能良好时，外科医生可以进行解剖型全肩关节置换术。该手术用模拟自然关节形态的人工部件替换磨损的骨面。这是肩袖健康时的标准治疗方法。

有时，肩袖会出现撕裂或功能减弱。缺乏这些肌腱的支持，关节的肱骨头会移位。此时，外科医生可能会建议进行反式全肩关节置换术。该手术将“球”与“窝”的位置互换，利用三角肌而非撕裂的肌腱来抬起手臂。这种设计有助于在肩袖受损的情况下恢复活动能力。

术后肩关节的运动方式会发生变化。肩胛骨在手臂运动中承担更多工作。这是正常且预期的现象。新的人工关节设计允许全范围活动，尽管运动模式与健康肩关节有所不同。

人工关节设计已显著改进。现代假体贴合更精确，运动更自然。然而，这些假体的使用寿命仍是活跃患者关注的问题。较年轻或活动量较大的患者可能会更快磨损人工部件。外科医生将根据您具体的关节损伤程度和活动水平选择最佳方案。

我们能采取的措施

我们总是从非手术方案开始，尤其是当您的退行性关节炎处于中度或轻度阶段时。您的外科医生可能会首先建议您进行自我管理和物理治疗。这种方法侧重于保持肩关节的活动能力，并加强周围肌肉以减轻关节压力。在考虑更侵入性的步骤之前，您应给予保守治疗充分的尝试机会。这是帮助您在不动刀的情况下管理疼痛并维持功能的标准一线防御措施。

如果轻柔的活动和锻炼不足以缓解症状，我们将转向药物管理以控制您的症状。这通常涉及使用止痛药和抗炎药来减轻肿胀和不适。您的外科医生还可能讨论注射治疗。皮质类固醇注射可以在有限时间内提供显著的疼痛缓解，帮助您恢复日常活动。其他选项如透明质酸或富血小板血浆（PRP）注射有时用于润滑关节或促进愈合，尽管其疗效持续时间各不相同。这些治疗并不能治愈关节炎，但它们可以为您争取时间，并在您管理病情期间提高生活质量。

仅当保守治疗达到极限且您的疼痛仍然严重时，才会考虑手术。在此阶段，您的外科医生可能会建议进行肩关节置换术，也称为关节成形术。该手术用人工部件替换关节的受损部分，以恢复平滑的运动并缓解疼痛。具体的置换类型取决于您的肩袖健康状况和骨骼损伤的程度。例如，如果您的肩袖完整，解剖型全肩关节置换术是金标准；而对于涉及肩袖损伤的更复杂病例，通常使用反式全肩关节置换术。这些手术治疗被认为对严重病例有效，并能显著且持续地改善您使用手臂的能力。

预期情况

肩关节骨关节炎是一种常见的疾病，会导致关节面磨损。若不进行治疗，症状通常会持续存在并随时间推移而加重。许多患者会经历持续的疼痛和僵硬，从而限制日常活动。如果影像学检查显示您仅有轻度关节炎迹象，与患有严重关节炎的患者相比，您感到手术效果不足的可能性高出约七倍。这凸显了您的外科医生为何会根据疾病分期仔细匹配治疗方案。

若管理得当，关节置换等手术选择可提供显著的缓解。大多数患者在疼痛和功能方面会看到明显改善。对于肩袖完整的患者，解剖型人工关节置换和反式人工关节置换均能取得良好的效果。特别是反式关节置换，在这一群体中短期内的并发症发生率较低。即使您的外科医生在手术过程中需要改为进行反式关节置换，您的预后很可能与从一开始就计划进行该手术的患者相当。

长期预后各不相同。虽然许多患者能享受持续的改善，但植入物的使用寿命仍是一个关注点，尤其是如果您活动量较大。某些类型的置换术后超过 10 年，部分患者仍会持续存在疼痛或出现骨质侵蚀。此外，在接受解剖型关节置换术后 12 年内，约 16% 的患者会在肩锁关节（肩部顶端的突起处）发生骨关节炎。您肩部前侧的力量可能需要两年时间才能完全恢复正常，尽管您很可能会看到较术前有所改善。

康复是一个过程，而非单一事件。您应预期在数周和数月内取得渐进式的进展。虽然疼痛通常会减轻，但完全恢复力量需要时间。您的外科医生将指导您度过这一阶段，但了解某些限制或不适可能会持续存在，有助于建立现实的期望。目标是恢复功能并减轻疼痛，使您能够回归对您最重要的活动。

何时就诊

肩关节关节炎很常见，且常随年龄增长而加重。如果您有持续不缓解的疼痛，即使休息后仍无改善，请咨询全科医生（GP）。如果您感到无力、不稳定，或肩关节出现卡住或脱位感，应寻求专科医生评估。这些症状可能干扰睡眠或工作。疼痛突然加重需要引起重视。对于老年女性而言，隐匿性肩痛可能提示快速破坏性关节炎，这种情况尤其需要关注。您的外科医生可能会使用影像学检查来区分感染与磨损性关节炎。早期评估有助于管理症状并制定治疗方案，包括潜在的关节置换术。

Reviewed by Kieran Hirpara · 27 April 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Overview

  • Standardization of outcome assessment following treatment of shoulder arthritis is needed [1].
  • Shoulder arthritis is common [2].
  • Management strategies for shoulder arthritis, especially in young patients, continue to evolve [2].
  • Significant improvements in implant design have occurred for shoulder arthritis management [2].
  • Implant longevity remains a concern in more active patients with shoulder arthritis [2].
  • Anatomic total shoulder arthroplasty (ATSA) is the benchmark for surgical treatment of glenohumeral arthritis with an intact cuff [19].
  • Reverse total shoulder arthroplasty (RTSA) has gained popularity for rotator cuff arthropathy and other complex indications [19].
  • Knowledge of the array of shoulder prostheses currently available and their indications can lead to optimized patient outcomes [11].
  • Use of treatment algorithms can lead to optimized patient outcomes in shoulder arthroplasty [11].
  • Total shoulder arthroplasty did not provide a clinically important advantage over hemiarthroplasty in terms of patient-reported pain, function, or adverse effects [24].
  • The evidence comparing total shoulder arthroplasty to hemiarthroplasty is of low quality [24].
  • Patients with glenohumeral osteoarthritis converted intraoperatively to reverse shoulder arthroplasty (RSA) had outcomes comparable to those who underwent total shoulder arthroplasty [3].
  • Reverse shoulder arthroplasty provides optimal outcomes with low complication rates across a short term of follow-up for glenohumeral osteoarthritis with an intact rotator cuff [4].
  • Patients with mild radiographic signs of arthritis have about sevenfold higher odds of failing to achieve the minimum clinically important difference (MCID) after anatomic total shoulder replacement compared to patients with severe arthritis [5].
  • The Western Ontario Osteoarthritis of the Shoulder Index (WOOS) is recommended for continued use in shoulder arthroplasty registries and observational studies [7].
  • A clear standardized set of shoulder arthroplasty complication definitions is lacking [8].
  • Both augmented and standard anatomic total shoulder arthroplasty can provide satisfactory and sustained improvements in patient-reported outcomes in patients with acquired glenoid retroversion due to glenohumeral osteoarthritis [26].

Anatomy & Pathophysiology

  • Pathoanatomic metrics with identified threshold values can discriminate glenoid types in shoulders with primary glenohumeral osteoarthritis [6].
  • Measurement of humeral subluxation in the glenoid hull plane may be more accurate than measurement in the scapular plane [27].
  • Scapular kinematics in patients with shoulder arthroplasty are influenced by the implementation of external loads, but not by the type of load [34].
  • Scaption kinematics in reverse shoulder arthroplasty do not change after the sixth postoperative month [35].
  • Elliptical and spherical humeral heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty [37].
  • Geometric analysis of the prosthetic shoulder is precise [38].
  • Reverse total shoulder arthroplasty (RTSA) shoulders maintain the same anterior and posterior deltoid muscle moment-arm patterns as healthy shoulders but exhibit much greater intersubject variation and larger moment-arm magnitudes [41].
  • In RTSA, although the teres minor external rotation moment arm is higher than in a normal shoulder, decreased length could impair force generation [42].
  • Reverse total shoulder arthroplasty alters humerothoracic, scapulothoracic, and glenohumeral motion during weighted scaption [43].
  • Custom, non-spherical prosthetic heads more accurately replicate head shape, rotational range of motion, and glenohumeral joint kinematics compared with commercially available spherical prosthetic heads when compared to the native humeral head [44].
  • The scapulothoracic contribution to overall shoulder movement is significantly increased in patients with reverse total shoulder arthroplasty compared with a healthy shoulder [47].
  • Shoulders with rotator cuff tears require considerable compensatory deltoid function to prevent abduction motion loss [51].
  • Anatomic total shoulder arthroplasty results in tendon-metal contact and higher tendon contact pressures compared to the native shoulder [52].
  • The combination of altered resting scapular posture and restricted scapulothoracic range of motion could prohibit glenohumeral rotation required to reach internal rotation in adduction [55].
  • Glenosphere configuration can be modified to increase range of movement in reverse shoulder arthroplasty [56].

Classification

  • Pathoanatomic metrics with identified threshold values can be used to discriminate glenoid types in shoulders with primary glenohumeral osteoarthritis [6].
  • Anatomic patterns of glenoid bone loss exist for different classes of glenohumeral arthritis [14].
  • Shoulders presenting with posterior subluxation (B types) remained posteriorly subluxed over a decade [18].
  • Concentric arthritis developed an eccentric pattern 20% of the time over a decade [18].
  • Measurement of humeral subluxation in the glenoid hull plane may be more accurate than in the scapular plane [27].
  • A 3-dimensional classification system using combined humeroscapular alignment and glenoid erosion can be applied to describe degenerative glenohumeral arthritis comprehensively [36].
  • A small lateral extension and less posterior rotation of the acromion is associated with shoulder osteoarthritis and is present in almost all types and subtypes of glenoid morphology [40].
  • Osteoarthritic humeral head morphology varies significantly from normal, characterized by larger spherical diameters [58].
  • Osteoarthritic humeral head morphology does not vary as a function of the Walch classification between symmetric and asymmetric glenoids [58].

Clinical Presentation

  • Shoulder arthritis is a common condition [2].
  • Management strategies for shoulder arthritis, particularly in young patients, continue to evolve with significant improvements in implant design, although longevity remains a concern in more active patients [2].
  • Patients with mild radiographic signs of arthritis have about sevenfold higher odds of failing to achieve the minimum clinically important difference (MCID) after anatomic total shoulder replacement compared to patients with severe arthritis [5].
  • Pathoanatomic metrics with identified threshold values can be used to discriminate glenoid types in shoulders with primary glenohumeral osteoarthritis [6].
  • Rapidly destructive arthrosis of the shoulder joints should be considered in the differential diagnosis of elderly women with insidious shoulder pain [10].
  • Increased age is the main determinant of radiological changes in shoulder osteoarthritis, as well as pain [12].
  • Shoulders presenting with posterior subluxation (B types) remained posteriorly subluxed, while concentric arthritis developed an eccentric pattern 20% of the time over a decade [18].
  • Arthritic B2 glenoids are common, and their maximal erosion is usually posteroinferior [48].
  • F-18-FDG PET/CT effectively differentiates septic shoulder arthritis from varying stages of osteoarthritis [22].

Investigations

  • Standardization of outcome assessment is needed following treatment of shoulder arthritis [1].
  • Pathoanatomic metrics with identified threshold values can discriminate glenoid types in shoulders with primary glenohumeral osteoarthritis [6].
  • Rapidly destructive arthrosis should be considered in the differential diagnosis of elderly women with insidious shoulder pain [10].
  • Increased age is the main determinant of radiological changes in shoulder osteoarthritis [12].
  • Increased age is the main determinant of pain in shoulder osteoarthritis [12].
  • Anatomic patterns of glenoid bone loss exist for different classes of glenohumeral arthritis [14].
  • F-18-FDG PET/CT effectively differentiates septic shoulder arthritis from varying stages of osteoarthritis [22].
  • In healthy/nonosteoarthritic shoulders, increased glenoid retroversion is associated with decreased anterior glenoid offset [31].
  • Additional research is required to document the clinical value of new technologies to patients with glenohumeral arthritis [32].
  • MRI offers a more precise method of determining glenoid version compared with x-ray imaging for preoperative osseous imaging in total shoulder arthroplasty [57].
  • The critical shoulder angle is an effective radiographic parameter associated with rotator cuff tears and osteoarthritis [63].
  • Three-dimensional CT reconstruction allows for reliable evaluation of the scapulohumeral relationship [64].
  • Three-dimensional CT reconstruction reveals significant posterior translation of the humeral head in osteoarthritic shoulders compared to nonpathologic controls [64].
  • Significant posterior translation of the humeral head in osteoarthritic shoulders supports the pathomechanism of glenoid component loosening [64].
  • A quantitative method for determining medial migration of the humeral head on plain radiographs is inexpensive, practical, and reproducible after shoulder arthroplasty [67].
  • Cystic disease in the glenoid did not affect functional outcome after total shoulder arthroplasty with minimum 5-year follow-up [68].
  • Cystic disease in the glenoid did not affect the presence of radiographic glenoid loosening after total shoulder arthroplasty with minimum 5-year follow-up [68].
  • Three significantly differently oriented posterior erosion patterns (posterior-superior, posterior-central, and posterior-inferior) were distinguished in shoulders demonstrating posterior wear on axillary imaging [69].

Treatment

Non-Operative Management

  • Nonoperative modalities should be utilized before surgical options, particularly for patients with moderate-to-mild shoulder osteoarthritis [17].

Surgical Management: General Principles and Indications

  • Anatomic total shoulder arthroplasty (ATSA) is the benchmark for surgical treatment of glenohumeral arthritis with an intact rotator cuff [19].
  • Reverse total shoulder arthroplasty (RTSA) has gained popularity for rotator cuff arthropathy and other complex indications [19].
  • Surgical treatments like arthroplasty are considered effective for severe cases of shoulder osteoarthritis [17].
  • Knowledge of the array of shoulder prostheses currently available and the indications for each, as well as the use of treatment algorithms, can lead to optimized patient outcomes [11].
  • Shoulder arthritis is common, and management strategies, especially in young patients, continue to evolve with significant improvements in implant design [2].
  • Longevity of implants remains a concern in more active patients with shoulder arthritis [2].

Surgical Management: Anatomic Total Shoulder Arthroplasty (ATSA)

  • Patients with mild radiographic signs of arthritis have about sevenfold higher odds of failing to achieve the minimum clinically important difference (MCID) after anatomic total shoulder replacement compared to patients with severe arthritis [5].
  • Both augmented and standard anatomic total shoulder arthroplasty can provide satisfactory and sustained improvements in patient-reported outcomes in patients with acquired glenoid retroversion due to glenohumeral osteoarthritis [26].
  • There was no clinically or statistically significant difference in the Oxford Shoulder Score results between groups with and without glenoid cementation in total shoulder arthroplasty for degenerative arthritis of the shoulder [28].
  • Total shoulder arthroplasty (TSA) is superior to hemiarthroplasty for treating end-stage glenohumeral arthritis refractory to conservative treatment in patients 30 to 50 years old, resulting in greater cost savings, fewer revision procedures, and greater quality-adjusted life years (QALYs) gained [65].

Surgical Management: Reverse Total Shoulder Arthroplasty (RTSA)

  • Patients with glenohumeral osteoarthritis converted intraoperatively to reverse shoulder arthroplasty (RSA) had outcomes comparable to those who underwent total shoulder arthroplasty [3].
  • Reverse shoulder arthroplasty provides optimal outcomes with low complication rates across a short term of follow-up for glenohumeral osteoarthritis with an intact rotator cuff [4].

Surgical Management: Surface Replacement Arthroplasty

  • Cemented surface replacement arthroplasty (CSRA) provides good long-term symptomatic and functional results in the treatment of glenohumeral arthropathy in patients aged younger than 50 years in 81.6% of the patients [9].
  • Patients undergoing total shoulder arthroplasty with an asymmetric glenoid component for osteoarthritis achieve satisfactory mid-term pain relief and improvement in function; however, instability is not always corrected [50].

Surgical Management: Arthroscopic and Other Procedures

  • The authors recommend a systematic, inclusive approach to the array of pathologies encountered in the setting of early glenohumeral arthritis known as the Comprehensive Arthroscopic Management (CAM) procedure [16].
  • Scapulothoracic fusion resulted in improvements in functional outcomes scores, with most patients meeting or exceeding the minimum clinically important difference for recalcitrant scapular winging [53].

Outcome Assessment and Registry Data

  • The Western Ontario Osteoarthritis of the Shoulder Index (WOOS) is recommended for continued use in shoulder arthroplasty registries and observational studies [7].
  • The PROMIS Global-10 appears to have limited utility in the evaluation of patients with shoulder arthritis both preoperatively and after total shoulder arthroplasty [33].
  • A study of 1,270 individual patients from eleven centers demonstrated significant improvement in patient-reported outcomes at 1 and 2 years post-surgery for a polyethylene glenoid with a fluted peg, establishing a benchmark for early clinical value [54].

Standardization and Complications

  • There is a need for standardization of outcome assessment following treatment of shoulder arthritis [1].
  • A clear standardized set of shoulder arthroplasty complication definitions is lacking [8].

Complications

  • Standardized definitions for shoulder arthroplasty complications are lacking [8].
  • Standardization of outcome assessment following treatment of shoulder arthritis is needed [1].
  • Longevity of implants remains a concern in more active patients with shoulder arthritis [2].
  • Total shoulder arthroplasty is associated with high mid-term complication rates due to instability and loosening in B2 glenoids [45].
  • Symptomatic acromioclavicular joint osteoarthritis occurred in 15.9% of patients after total anatomic shoulder replacement with follow-up of up to 12 years [15].
  • No case of glenoid loosening occurred at 3 years' follow-up in revision arthroplasty with a hip-inspired computer-assisted design/computer-assisted manufacturing implant for glenoid-deficient shoulders [21].
  • Total shoulder arthroplasty did not provide a clinically important advantage over hemiarthroplasty in terms of adverse effects, although the evidence was of low quality [24].

Recovery

  • Standardization of outcome assessment is needed following treatment of shoulder arthritis [1].
  • Implant longevity remains a concern in more active patients with shoulder arthritis [2].
  • Patients with glenohumeral osteoarthritis converted intraoperatively to reverse shoulder arthroplasty (RSA) had outcomes comparable to those who underwent total shoulder arthroplasty (TSA) [3].
  • Reverse shoulder arthroplasty provides optimal outcomes with low complication rates across a short term of follow-up for glenohumeral osteoarthritis with an intact rotator cuff [4].
  • Primary anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) patients with osteoarthritis and an intact rotator cuff with no previous history of shoulder surgery had similar clinical and radiographic outcomes at a mean of 41 months follow-up [23].
  • Surgeons may consider using reverse arthroplasty in cases of primary shoulder arthritis with a critical shoulder angle of 35 degrees or greater [29].
  • The PROMIS Global-10 has limited utility in the evaluation of patients with shoulder arthritis both preoperatively and after TSA [33].
  • Subscapularis strength returned to normal in only a minority of patients at 2 years after shoulder arthroplasty, although significant strength improvement from baseline was observed [60].
  • There is a substantive subgroup with continuing pain and a high rate of glenoid bone erosion after 10 years following humeral head replacement for osteoarthritis [70].

Key Evidence

  • [L1] The present review highlights the need for standardization of outcome assessment following treatment of shoulder arthritis. (10.1177/1758573215622385)
  • [L5] Shoulder arthritis is common, and management strategies, especially in young patients, continue to evolve with significant improvements in implant design, though longevity remains a concern in more active patients. (10.1016/j.csm.2018.07.001)
  • [L3] Patients with glenohumeral osteoarthritis converted intraoperatively to RSA had outcomes comparable to those who underwent total shoulder arthroplasty. (10.1016/j.jse.2015.01.005)
  • [L4] Reverse shoulder arthroplasty provides optimal outcomes with low complication rates across a short term of follow-up for glenohumeral osteoarthritis with an intact rotator cuff. (10.1016/j.jse.2021.06.010)
  • [Paper] Patients with mild radiographic signs of arthritis have about sevenfold higher odds of failing to achieve the minimum clinically important difference (MCID) after anatomic total shoulder replacement compared to patients with severe arthritis. (10.1097/corr.0000000000002747)
  • [L4] Pathoanatomic metrics with the identified threshold values can be used to discriminate glenoid types in shoulders with primary glenohumeral osteoarthritis. (10.1016/j.jse.2021.03.140)
  • [L4] The authors recommend the continued use of WOOS in shoulder arthroplasty registries and observational studies. (10.1186/s12891-023-06578-5)
  • [L1] A clear standardised set of shoulder arthroplasty complication definitions is lacking. (10.1007/s00402-017-2635-9)
  • [L4] CSRA provides good long-term symptomatic and functional results in the treatment of glenohumeral arthropathy in patients aged younger than 50 years in 81.6% of the patients. (10.1016/j.jse.2014.11.035)
  • [L4] This condition should be considered in the differential diagnosis of elderly women with insidious shoulder pain. (10.1016/j.jse.2014.10.020)
  • [L5] Knowledge of the array of shoulder prostheses currently available and the indications for each, as well as the use of treatment algorithms, can lead to optimized patient outcomes. (10.5435/00124635-200907000-00002)
  • [L3] This study shows that increased age is the main determinant of radiological changes in shoulder OA, as well as pain. (10.1186/s13018-022-03137-x)
  • [L4] These data demonstrate an anatomic pattern of glenoid bone loss for different classes of glenohumeral arthritis. (10.1007/s12306-016-0406-3)
  • [L4] Symptomatic ACJ OA occurred in 15.9% of patients after total anatomic shoulder replacement with follow-up of up to 12 years. (10.1177/17585732221114796)
  • [L4] The authors recommend a systematic, inclusive approach to the array of pathologies encountered in the setting of early glenohumeral arthritis: the Comprehensive Arthroscopic Management (CAM) procedure. (10.1016/j.arthro.2022.01.033)
  • [L5] The article provides an overview of available treatments for shoulder osteoarthritis, noting that nonoperative modalities should be utilized before surgical options, particularly for patients with moderate-to-mild disease, while surgical treatments like arthroplasty are considered effective for severe cases. (10.1155/2013/370231)
  • [L4] Shoulders presenting with posterior subluxation (B types) remained posteriorly subluxed, while concentric arthritis developed an eccentric pattern 20% of the time. (10.1016/j.jse.2020.05.021)
  • [L4] At 3 years' follow-up, pain and clinical scores improved significantly and no case of glenoid loosening occurred. (10.1016/j.jse.2013.05.004)
  • [L3] F-18-FDG PET/CT effectively differentiates septic shoulder arthritis from varying stages of osteoarthritis. (10.1016/j.jse.2025.01.047)
  • [L3] At a mean of 41 month follow-up, primary aTSA and rTSA patients with OA and an intact rotator cuff with no previous history of shoulder surgery had similar clinical and radiographic outcomes. (10.5435/jaaos-d-22-00014)
  • [L1] Total shoulder arthroplasty did not provide a clinically important advantage over hemiarthroplasty in terms of patient-reported pain, function, nor adverse effects; however, the evidence on this topic was of low quality. (10.1097/corr.0000000000001523)
  • [L3] Both augmented and standard anatomic total shoulder arthroplasty can provide satisfactory and sustained improvements in patient-reported outcomes in patients with acquired glenoid retroversion due to glenohumeral osteoarthritis. (10.1016/j.jse.2021.12.016)
  • [L4] Measurement in the glenoid hull plane may be more accurate than in the scapular plane. (10.1016/j.jse.2017.01.027)
  • [L3] There was no clinically or statistically significant difference in the Oxford Shoulder Score results between the two groups. (10.1016/j.jse.2013.08.022)
  • [L3] These data suggest that surgeons may consider using reverse arthroplasty in cases of primary shoulder arthritis with a critical shoulder angle of 35 degrees or greater. (10.1016/j.jse.2021.08.003)
  • [L4] In healthy/nonosteoarthritic shoulders, an increased glenoid retroversion is associated with a decreased anterior glenoid offset. (10.1016/j.jse.2023.09.031)
  • [L4] Additional research is required to document the clinical value of these new technologies to patients with glenohumeral arthritis. (10.2106/jbjs.20.01853)
  • [L3] The Global-10 appears to have limited utility in the evaluation of patients with shoulder arthritis both preoperatively and after TSA. (10.1016/j.jse.2020.10.021)
  • [L4] Scapular kinematics of patients with shoulder arthroplasty was influenced by implementation of external loads, but not by the type of load. (10.1016/j.clinbiomech.2012.04.009)
  • [L4] Scaption kinematics of reverse shoulder arthroplasty do not change after the sixth postoperative month. (10.1016/j.clinbiomech.2018.07.005)
  • [L3] The 3D classification system using combined humeroscapular alignment and glenoid erosion can be applied to describe the disease comprehensively. (10.1177/23259671221110512)
  • [L5] A gained understanding of the consequences of implant head shape in TSA may guide future surgical implant choice for better recreation of native shoulder kinematics and potentially improved patient outcomes. (10.1186/s12891-023-06273-5)
  • [L2] Geometric analysis of the prosthetic shoulder is precise. (10.1007/s00402-012-1580-x)
  • [L3] A small lateral extension and less posterior rotation of the acromion is associated with shoulder osteoarthritis and is present in almost all types and subtypes of glenoid morphology. (10.1016/j.jse.2021.01.018)
  • [L5] RTSA shoulders maintain the same anterior and posterior deltoid muscle moment-arm patterns as healthy shoulders but show much greater intersubject variation and larger moment-arm magnitudes. (10.1016/j.jse.2015.09.015)
  • [L5] Even if TM external rotation moment arm is higher in RTSA than in a normal shoulder, the decreased length could impair its force generation. (10.1016/j.jse.2014.08.019)
  • [L5] This commentary highlights that reverse total shoulder arthroplasty alters humerothoracic, scapulothoracic, and glenohumeral motion during weighted scaption, emphasizing the need to integrate biomechanical studies, computer modeling, and dynamic clinical evaluations to develop a roadmap for precision rTSA. (10.1097/corr.0000000000002383)
  • [L5] The custom, non-spherical prosthetic head more accurately replicated the head shape, rotational range of motion, and glenohumeral joint kinematics than the commercially available, spherical prosthetic head compared with the native humeral head. (10.1016/j.jse.2013.01.002)
  • [L5] Total shoulder arthroplasty may have reasonable short-term results but is associated with high mid-term complication rates due to instability and loosening in B2 glenoids. (10.1016/j.jse.2013.06.017)
  • [L4] The ST contribution to overall shoulder movement is significantly increased in patients with an rTSA compared with a healthy shoulder. (10.1016/j.jse.2024.12.018)
  • [L4] Arthritic B2 glenoids are common, and their maximal erosion is usually posteroinferior. (10.1016/j.jse.2015.01.007)
  • [L4] Patients undergoing total shoulder arthroplasty with an asymmetric glenoid component for osteoarthritis achieve satisfactory mid-term pain relief and improvement in function; however, instability is not always corrected. (10.1007/s11999-007-0104-4)
  • [L5] Shoulders with rotator cuff tears require considerable compensatory deltoid function to prevent abduction motion loss. (10.1177/0363546518768276)
  • [L5] Anatomic total shoulder arthroplasty results in tendon-metal contact and higher tendon contact pressures compared to the native shoulder. (10.1016/j.jse.2018.04.017)
  • [L4] Scapulothoracic fusion resulted in improvements in functional outcomes scores, with most patients meeting or exceeding the minimum clinically important difference. (10.1097/corr.0000000000002673)
  • [L4] The study establishes a benchmark for early clinical value of new glenoid components by demonstrating significant improvement in patient-reported outcomes at 1 and 2 years post-surgery across a large multicenter cohort. (10.1007/s00264-018-4213-3)
  • [L4] The combination of altered resting scapular posture and restricted scapulothoracic range of motion could prohibit glenohumeral rotation required to reach internal rotation in adduction. (10.1016/j.jse.2022.10.009)
  • [L5] Glenosphere configuration can be modified to increase range of movement in reverse shoulder arthroplasty. (10.1302/0301-620x.100b9.bjj-2018-0264.r1)
  • [L3] MRI is useful for preoperative osseous imaging for total shoulder arthroplasty because it offers a more precise method of determining glenoid version compared with x-ray imaging. (10.1016/j.jse.2012.10.036)
  • [L4] Osteoarthritic humeral head morphology varies significantly from normal, with larger spherical diameters, but does not vary as a function of the Walch classification between symmetric and asymmetric glenoids. (10.1016/j.jse.2015.08.047)
  • [L4] Although significant strength improvement from baseline was observed at 2 years after shoulder arthroplasty, subscapularis strength returned to normal in only a minority of patients. (10.1016/j.jse.2014.06.042)
  • [L4] The CSA is an effective radiographic parameter that is associated with rotator cuff tears and osteoarthritis. (10.1136/jisakos-2018-000255)
  • [L4] The study demonstrates that 3D CT reconstruction allows for reliable evaluation of the scapulohumeral relationship, revealing significant posterior translation of the humeral head in osteoarthritic shoulders compared to nonpathologic controls, which supports the pathomechanism of glenoid component loosening. (10.1016/j.jse.2016.02.035)
  • [L2] Treatment of end-stage glenohumeral arthritis refractory to conservative treatment in patients 30 to 50 years old in the United States with TSA, instead of hemiarthroplasty, would result in greater cost savings, avoid a substantial number of revision procedures, and result in greater years of satisfactory or excellent patient outcomes and greater QALYs gained. (10.1007/s11999-016-4991-0)
  • [L3] This is an inexpensive, practical, and reproducible method that can be used to determine the rate of medial migration of the humeral head on plain radiographs after shoulder arthroplasty. (10.1016/j.jse.2010.03.010)
  • [L3] Cystic disease did not affect functional outcome or the presence of radiographic glenoid loosening. (10.1016/j.jse.2017.10.035)
  • [L4] Three significantly differently oriented wear patterns (posterior-superior, posterior-central, and posterior-inferior) were distinguished in shoulders demonstrating posterior wear on axillary imaging. (10.1016/j.jse.2021.04.028)
  • [L4] However, there is a substantive subgroup with continuing pain and a high rate of glenoid bone erosion after 10 years. (10.1016/j.jse.2017.10.017)

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a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.