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Education · shoulder

Shoulder Arthritis Info Evidence

Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed

Related shoulder topics. Total shoulder replacement , Reverse shoulder replacement , Revision shoulder replacement and Cuff-tear arthropathy .

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Video transcript

Shoulder arthritis develops when the smooth cartilage lining the ball-and-socket joint gradually wears away. As the bones begin to rub together, you feel a deep ache, stiffness, and sometimes a grinding or catching. Reaching overhead, out to the side, or behind your back becomes harder and more painful. The ache is often worst with use, and can disturb your sleep at night. It usually comes on slowly over years, and is more common with age, or after an old injury. Many shoulders are managed for a long time without surgery, especially in the earlier stages. Gentle exercises, guided by a physiotherapist, help keep movement and strength around the joint. Anti-inflammatory medication can settle the painful flares, and a cortisone injection into the joint can give useful relief. Easing heavy overhead activities takes some of the strain off the worn joint. When the pain becomes constant and limits daily life despite these measures, a joint replacement can help. A shoulder replacement resurfaces the worn joint with smooth implants, much like a hip or knee replacement. When the rotator cuff tendons are intact, an anatomic replacement restores the natural ball-and-socket. When the cuff is worn or torn, a reverse replacement is used, which swaps the ball and socket around so the remaining muscles can power the arm. It is done under anaesthetic through an incision at the front of the shoulder, usually with a short hospital stay. The aim is to relieve the pain, and restore comfortable, useful movement. The arm rests in a sling for around six weeks, to protect the new joint while it settles. Physiotherapy starts gently within the first few weeks, and moves through stages, protected movement first, then active movement, and strengthening later on. Pain relief is usually noticed early, with movement and strength building over the following months. It asks for patience, as a shoulder replacement keeps improving for a year or more. Keeping up the program gives the best long-term result.

What you're feeling

Shoulder arthritis is a common condition where the smooth cartilage in your shoulder joint wears down. This wear-and-tear process causes the bones to rub against each other. As the condition progresses, you may notice that your shoulder feels stiff and painful. The pain often starts gradually but can become sharp or achy. It typically settles in the outer part of your shoulder and may travel down your upper arm.

Your symptoms often follow a predictable pattern. You might feel stiffness when you first wake up in the morning. This stiffness usually eases as you move around, but it can return after you have been active. Tasks that require lifting your arm above shoulder height become difficult. You may struggle to reach items on high shelves or comb your hair. Simple movements, like reaching into the back seat of a car or putting on a jacket, can trigger a flare-up of pain.

Night pain is also a frequent complaint. Many patients find it hard to sleep on the affected side because the pressure aggravates the inflamed joint. This can lead to fragmented sleep and daytime fatigue. While rest may provide temporary relief, prolonged inactivity can make the joint stiffer.

The severity of your symptoms often correlates with the stage of arthritis. If you have mild signs of arthritis on imaging, you might not feel significant pain yet, but you may still struggle to achieve meaningful improvement after surgery compared to those with more advanced disease. In some cases, particularly in older women, the pain can develop insidiously and worsen rapidly. Increased age is a main factor in how much radiological change and pain you experience.

If your shoulder feels unstable or shifts out of place, you might notice a catching sensation. This is more common if the joint has developed an eccentric pattern of wear. Understanding these specific symptoms helps your surgeon tailor a management plan. Whether you are considering non-surgical options or discussing implant designs, recognizing these signs ensures we address your specific needs.

What's actually happening

Shoulder arthritis is a common wear-and-tear condition. It affects the joint where your upper arm bone meets your shoulder blade. Think of this joint like a ball-and-socket toy. The ball is the head of your humerus. The socket is the glenoid on your shoulder blade. In a healthy shoulder, smooth cartilage covers both surfaces. This cartilage acts like a shock absorber. It lets the bones glide past each other with almost no friction.

In shoulder arthritis, this protective cartilage breaks down. It thins out or wears away completely. Without this cushion, the bones rub directly against each other. This causes pain and stiffness. Your shoulder may feel like it is grinding or catching. The joint space narrows, and the bones may change shape. This is why simple movements become difficult and painful.

Your shoulder relies on a group of tendons called the rotator cuff. These tendons act like ropes that stabilize the ball in the socket. When arthritis damages the joint, it often affects these tendons too. If the cuff is torn or weak, your shoulder loses stability. Your body then tries to compensate. It uses your large deltoid muscle to lift your arm instead. This changes how your shoulder moves. Your shoulder blade may shift position to help you move. This compensation can lead to further strain and altered movement patterns.

We understand that these changes feel confusing and limiting. Your surgeon explains that the goal of treatment is to restore smooth movement. We use advanced joint replacement designs to mimic the natural ball-and-socket structure. These implants replace the worn surfaces with smooth, durable materials. This restores the shock-absorbing function and stabilizes the joint. By addressing the root cause, we help reduce pain and improve your ability to move freely again.

What we can do about it

The approach Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, takes in our clinic focuses on matching the treatment to your specific stage of arthritis. We believe in starting with the least invasive options first. This allows us to manage pain and maintain movement without surgery, particularly if your wear-and-tear arthritis is mild to moderate.

You can begin by adjusting daily activities to avoid positions that cause sharp pain. Gentle physiotherapy helps keep the joint mobile and strengthens the muscles around it to take pressure off the bone. We usually recommend giving this non-surgical care a fair trial for several weeks to see if it provides enough relief for your lifestyle.

If movement exercises are not enough, we discuss medical management to control inflammation and pain. This may include standard pain relievers or anti-inflammatory medications. We also consider injections into the joint. Cortisone injections reduce swelling and pain for a few months. Hyaluronic acid injections aim to lubricate the joint, while platelet-rich plasma (PRP) injections use your own blood components to support healing. The duration of relief varies, but these options can buy you time or help you stay active without surgery.

Surgery is considered when conservative care has reached its limit and your quality of life is significantly affected. At this stage, we discuss joint replacement. This procedure replaces the damaged bone and cartilage with artificial components to restore smooth movement and eliminate pain. We review the specific type of replacement that fits your anatomy and activity level, ensuring you understand the long-term benefits and commitments involved in the decision.

What to expect

Shoulder arthritis is a common condition. It typically causes persistent pain and stiffness that does not settle on its own. Without treatment, symptoms often continue to worsen over time. You may notice that daily tasks become increasingly difficult as the joint wears down further.

When managed with surgery, most people experience significant improvements in pain and function. Anatomic total shoulder replacement is the standard approach for patients with an intact rotator cuff. This procedure replaces the worn joint surfaces while preserving your natural shoulder mechanics. If your rotator cuff is damaged, a reverse shoulder replacement may be recommended. This design changes how the joint moves to compensate for the torn muscles. Both approaches aim to restore your ability to use your arm comfortably.

Recovery is a gradual process. You will likely feel noticeable relief from pain within the first few weeks. However, strength and full range of motion take longer to return. It can take several months to regain normal function. Subscapularis strength, which helps rotate your arm, returns to normal in only a minority of patients at two years after surgery. While you will see significant improvement from your baseline, some weakness may persist.

Implant longevity remains a concern for more active patients. The evidence shows that implants last well for many years, but they may wear out sooner if you place high demands on your shoulder. Some patients experience continuing pain or bone erosion after ten years following humeral head replacement. Additionally, symptomatic arthritis in the acromioclavicular joint occurs in 15.9% of patients after total anatomic shoulder replacement with follow-up of up to 12 years.

Outcomes vary based on your specific anatomy and health. Patients with mild signs of arthritis have about sevenfold higher odds of failing to achieve the minimum clinically important difference after anatomic total shoulder replacement compared to patients with severe arthritis. This means those with less visible damage on scans may not feel as dramatic a change as those with advanced wear.

If left untreated, the condition rarely improves. You may eventually require more complex interventions if conservative measures fail. Your surgeon will discuss which option best fits your lifestyle and joint condition. We aim to provide clear, realistic expectations so you can make an informed decision about your care.

When to see someone

Shoulder arthritis is common and often worsens with age. See your GP if you have persistent pain that does not improve with rest. Ask for a specialist review if you experience weakness, instability, or a feeling of locking or giving way. These symptoms can interfere with sleep or work. Sudden worsening of pain also warrants attention. While implant longevity is a concern for active patients, early assessment helps manage these issues. Your surgeon can determine if your condition is typical wear-and-tear or a rapidly destructive form. Proper evaluation ensures you receive the right care for your specific needs.

Reviewed by Kieran Hirpara · 27 April 2026.

Talk to your treating clinician for advice specific to you.

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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