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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 Aug 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，且关节盂缘周围已形成骨赘。 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，表现为肩关节内的保护性软骨磨损。这种磨损过程导致骨骼相互摩擦。您可能会感到肩部深处有酸痛感。疼痛常放射至上臂。有时也可向上延伸至颈部。

疼痛通常在活动时加重。简单的动作，如伸手去拿高处的架子或提起重物，都可能诱发疼痛。随着时间推移，日常活动会变得困难。您可能难以将衬衫塞进裤腰，或难以伸手到背后扣上内衣。患侧卧位睡眠常引起疼痛。许多患者发现夜间肩部疼痛加剧，从而干扰休息。

僵硬是另一个主要症状。您的肩部可能感觉紧绷，尤其是在早晨或长时间坐着之后。这种僵硬会限制您抬臂的范围。您在活动时可能会感觉到研磨感或听到咔哒声。这些感觉是因为光滑的关节面消失，无法再缓冲运动所致。

年龄在这些变化中起着重要作用。老年人通常表现出更明显的影像学改变和疼痛。然而，肩关节关节炎可影响不同生命阶段的人群。在某些情况下，病情进展迅速。这种快速破坏在老年女性中更为常见，表现为隐匿性、渐进性疼痛。

如果您存在肩关节半脱位（即肩关节的肱骨头向后滑脱），疼痛模式可能有所不同。虽然某些类型的关节炎在十年内发展为偏心性模式，但其他类型则保持位置固定。了解您具体的关节炎类型有助于您的外科医生制定个性化的治疗方案。

您并不孤单。管理策略随着植入物设计的改进而不断演变。虽然对于活动量较大的患者而言，假体的使用寿命仍是一个关注点，但有许多选择可以缓解您的疼痛并恢复功能。您的外科医生将评估您的具体症状和关节结构，以确定最适合您的治疗方案。

实际情况

肩关节关节炎是一种常见的退行性疾病。当覆盖在骨端的平滑组织（称为软骨）发生磨损时，就会引发此病。可以将软骨视为减震器。当软骨变薄时，您的骨头会相互摩擦。这会导致疼痛和僵硬。

您的肩关节由一个称为关节囊的囊状结构包裹。在关节内部，您的肱骨（上臂骨）与肩胛骨（肩胛片）相接。在健康的肩关节中，这些表面平滑滑动。而在关节炎情况下，它们之间的间隙变窄。骨头可能会发生形状改变。您的外科医生可以通过影像学检查看到这些变化。

有时，问题涉及抬起手臂的肌腱。这些是肩袖肌群。如果它们撕裂，您的肩关节会失去自然的平衡。您的三角肌（位于肩关节外侧的大肌肉）必须更用力地工作以移动手臂。这种代偿有助于保持一定的活动度，但会改变您肩关节的运动方式。

我们制定的治疗方案旨在解决这些特定的改变。对于某些患者，我们用人工部件替换磨损的表面。这称为关节置换术。我们根据您肌腱的健康状况和骨头形状选择置换类型。

如果您的肌腱完整，我们通常使用解剖型置换。这模拟了您自然的关节形状。如果您的肌腱受损，我们可能会使用反式置换。这改变了球窝关节的几何结构。它依赖您的三角肌提供动力，而不是受损的肌腱。

这两种方法都旨在恢复平滑的运动。它们减少了骨头与骨头之间的摩擦。这有助于缓解疼痛并改善功能。我们根据您独特的解剖结构定制植入物的形状。我们的目标是让您重新获得舒适活动的肩关节。

我们能做什么

在我们的诊所，Kieran Hirpara 博士根据关节炎对您日常生活的影响程度来制定治疗方案。我们从侵入性最小的选项开始。对于轻至中度的退行性关节炎，非手术治疗通常是第一步。这能让您的肩部在不进行手术的情况下得到缓解。

您可以从调整活动开始。避免提重物或引起剧烈疼痛的动作。轻柔的拉伸和强化练习有助于保持关节的活动度。物理治疗旨在改善您的活动范围并支持肩部周围的肌肉。我们通常建议先尝试这种方法数周，以观察是否能减轻您的不适。

如果活动调整不足以缓解症状，我们可能会建议药物治疗。这通常包括止痛药或抗炎药，以管理肿胀和疼痛。我们还可能提供肩部关节注射。皮质类固醇注射可以在一段时间内减轻炎症和疼痛。透明质酸或富血小板血浆（PRP）注射是其他可能有助于润滑关节或支持愈合的选项。这些治疗并不能治愈关节炎，但可以在您继续进行康复治疗的同时提供缓解。

当保守治疗未能带来足够改善，或关节炎严重时，会考虑手术治疗。全肩关节置换术或反式肩关节置换术等手术可以恢复功能并缓解疼痛。我们仅在非手术方法尝试过后，才会与您讨论这些选项。手术的选择取决于您的肩袖状况和骨骼形状。我们会一起回顾证据，以确保您了解益处和风险。例如，表面置换成形术在 50 岁以下的患者中，81.6% 的人取得了良好的长期结果。我们直白地呈现这一数据，以便您做出知情选择。您的外科医生将根据您的具体需求指导您进行下一步。

预期情况

肩关节骨关节炎是一种常见的退行性疾病。它通常会导致持续性的疼痛和僵硬，且无法自行缓解。尽管管理策略不断演进，但若不进行治疗，往往会导致持续不适和关节活动度逐渐丧失。

在接受关节置换手术管理后，大多数患者的疼痛和功能会得到显著改善。您可以预期在数个月内稳步恢复。临床数据显示，患者通常在术后两年内，其日常活动能力会有实质性提升。然而，重要的是要知道，并非所有人的力量都能完全恢复到正常水平。例如，在术后两年时，仅有少数患者的肩胛下肌力量恢复至正常水平。

植入物的使用寿命是一个关键考量因素，尤其是对于活跃的患者而言。肩关节植入物的耐用性是活跃患者所关注的问题。一些研究表明，在接受某些类型的置换术后十年，相当一部分患者可能会经历持续性疼痛或骨质侵蚀。

您的外科医生将根据您的具体解剖结构讨论最佳治疗方案。例如，与严重关节炎患者相比，轻度关节炎体征患者在解剖型全肩关节置换术后未能达到最小临床重要差异（MCID）的几率高出约七倍。相反，对于肩袖完整的患者，反式肩关节置换术在短期内能提供最佳疗效且并发症率低。

我们旨在通过选择适合您需求的术式来优化您的治疗效果。无论是进行解剖型还是反式置换，目标都是充分缓解疼痛并改善功能。虽然在某些广泛比较中，全肩关节置换术相较于半肩关节置换术并未显示出临床重要的优势，但诸如骨质缺损或肩袖完整性等个体因素会指导我们的选择。我们将帮助您了解针对您的身体和生活状况，哪些结果是现实的。

何时就医

若持续性肩痛经休息后无改善，请咨询全科医生。若出现无力、不稳或锁定感/打软腿感，应寻求专科医生评估。这些症状常干扰睡眠或工作。疼痛突然加重需及时就诊。肩关节骨关节炎常见，年龄增长是疼痛及影像学改变的主要驱动因素。若患者年轻且活跃，人工关节假体使用寿命仍是关注重点，因此早期评估有助于管理预期。老年女性可出现隐匿性疼痛的快速破坏性关节炎。若症状不典型或X线显示破坏性病变，应考虑痛风性关节炎或癌性关节炎。早期诊断可确保您获得针对具体病情的最适宜治疗。

Reviewed by Dr Kieran Hirpara · 7 August 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

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

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].
  • 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].
  • 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].
  • 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].
  • 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)

  • 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)

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 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].

Complications

  • Standardized definitions for shoulder arthroplasty complications are lacking [8].
  • 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

  • Patients with glenohumeral osteoarthritis converted intraoperatively to reverse shoulder arthroplasty (RSA) had outcomes comparable to those who underwent total shoulder arthroplasty (TSA) [3].
  • 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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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.