- Department of Sports Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian Liaoning, 116001, P.R.China;
Based on peer-reviewed systematic reviews and randomized controlled trials published between January 2000 and June 2019 with regards to the management of glenohumeral joint osteoarthritis (GJO), the American Academy of Orthopaedic Surgeons (AAOS) established the clinical practice guidelines for the treatment of GJO. The guidelines provided practice recommendations including risk factors, non-surgical treatment, surgical treatment, prosthesis selection, and perioperative management for GJO. The recommendations were graded according to different evidence strength. This paper interprets the guidline in order to provide reference for domestic medical workers.
Citation: XIANG Xianxiang. Interpretation of 2020 American Academy of Orthopaedic Surgeons (AAOS) on the Management of Glenohumeral Joint Osteoarthritis Evidence-Based Clinical Practice Guideline. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(11): 1403-1410. doi: 10.7507/1002-1892.202105085 Copy
1. | Singh JA, Sperling J, Buchbinder R, et al. Surgery for shoulder osteoarthritis. Cochrane Database Syst Rev, 2010, (10): CD008089. doi: 10.1002/14651858.CD008089.pub2. |
2. | Day JS, Lau E, Ong KL, et al. Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Shoulder Elbow Surg, 2010, 19(8): 1115-1120. |
3. | Bernstein DN, Keswani A, Ring D. Perioperative risk adjustment for total shoulder arthroplasty: are simple clinically driven models sufficient? Clin Orthop Relat Res, 2017, 475(12): 2867-2874. |
4. | Chalmers PN, Gupta AK, Rahman Z, et al. Predictors of early complications of total shoulder arthroplasty. J Arthroplasty, 2014, 29(4): 856-860. |
5. | Jiang JJ, Somogyi JR, Patel PB, et al. Obesity is not associated with increased short-term complications after primary total shoulder arthroplasty. Clin Orthop Relat Res, 2016, 474(3): 787-795. |
6. | Mahony GT, Werner BC, Chang B, et al. Risk factors for failing to achieve improvement after anatomic total shoulder arthroplasty for glenohumeral osteoarthritis. J Shoulder Elbow Surg, 2018, 27(6): 968-975. |
7. | Robinson WA, Wagner ER, Cofield RH, et al. Long-term outcomes of humeral head replacement for the treatment of osteoarthritis; a report of 44 arthroplasties with minimum 10-year follow-up. J Shoulder Elbow Surg, 2018, 27(5): 846-852. |
8. | Ödquist M, Hallberg K, Rahme H, et al. Lower age increases the risk of revision for stemmed and resurfacing shoulder hemi arthroplasty. Acta Orthop, 2018, 89(1): 3-9. |
9. | Rispoli DM, Sperling JW, Athwal GS, et al. Humeral head replacement for the treatment of osteoarthritis. J Bone Joint Surg (Am), 2006, 88(12): 2637-2644. |
10. | Leschinger T, Raiss P, Loew M, et al. Total shoulder arthroplasty: risk factors for intraoperative and postoperative complications in patients with primary arthritis. J Shoulder Elbow Surg, 2017, 26(3): e71-e77. |
11. | Wells DB, Holt AM, Smith RA, et al. Tobacco use predicts a more difficult episode of care after anatomic total shoulder arthroplasty. J Shoulder Elbow Surg, 2018, 27(1): 23-28. |
12. | Althoff AD, Reeves RA, Traven SA, et al. Smoking is associated with increased surgical complications following total shoulder arthroplasty: an analysis of 14, 465 patients. J Shoulder Elbow Surg, 2020, 29(3): 491-496. |
13. | Hatta T, Werthel JD, Wagner ER, et al. Effect of smoking on complications following primary shoulder arthroplasty. J Shoulder Elbow Surg, 2017, 26(1): 1-6. |
14. | Somerson JS, Neradilek MB, Service BC, et al. Clinical and radiographic outcomes of the ream-and-run procedure for primary glenohumeral arthritis. J Bone Joint Surg (Am), 2017, 99(15): 1291-1304. |
15. | Werner BC, Wong AC, Chang B, et al. Depression and patient-reported outcomes following total shoulder arthroplasty. J Bone Joint Surg (Am), 2017, 99(8): 688-695. |
16. | Blaine T, Moskowitz R, Udell J, et al. Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study. J Bone Joint Surg (Am), 2008, 90(5): 970-979. |
17. | Kwon YW, Eisenberg G, Zuckerman JD. Sodium hyaluronate for the treatment of chronic shoulder pain associated with glenohumeral osteoarthritis: a multicenter, randomized, double-blind, placebo-controlled trial. J Shoulder Elbow Surg, 2013, 22(5): 584-594. |
18. | Gartsman GM, Roddey TS, Hammerman SM. Shoulder arthroplasty with or without resurfacing of the glenoid in patients who have osteoarthritis. J Bone Joint Surg (Am), 2000, 82(1): 26-34. |
19. | Lo IK, Litchfield RB, Griffin S, et al. Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis. A prospective, randomized trial. J Bone Joint Surg (Am), 2005, 87(10): 2178-2185. |
20. | Mann T, Baumhauer JF, O’Keefe RJ, et al. High incidence of hemiarthroplasty for shoulder osteoarthritis among recently graduated orthopaedic surgeons. Clin Orthop Relat Res, 2014, 472(11): 3510-3516. |
21. | Garcia GH, Liu JN, Mahony GT, et al. Hemiarthroplasty versus total shoulder arthroplasty for shoulder osteoarthritis: a matched comparison of return to sports. Am J Sports Med, 2016, 44(6): 1417-1422. |
22. | Edwards TB, Kadakia NR, Boulahia A, et al. A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: results of a multicenter study. J Shoulder Elbow Surg, 2003, 12(3): 207-213. |
23. | Iannotti JP, Norris TR. Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg (Am), 2003, 85(2): 251-258. |
24. | Virk MS, Thorsness RJ, Griffin JW, et al. Short-term clinical outcomes of hemiarthroplasty with concentric glenoid reaming: the ream and run procedure. Orthopedics, 2018, 41(6): e854-e860. |
25. | Razmjou H, Stratford P, Kennedy D, et al. Pattern of recovery following total shoulder arthroplasty and humeral head replacement. BMC Musculoskelet Disord, 2014, 15: 306. doi: 10.1186/1471-2474-15-306. |
26. | Gowd AK, Garcia GH, Liu JN, et al. Comparative analysis of work-related outcomes in hemiarthroplasty with concentric glenoid reaming and total shoulder arthroplasty. J Shoulder Elbow Surg, 2019, 28(2): 244-251. |
27. | Krukenberg A, McBirnie J, Bartsch S, et al. Sidus stem-free shoulder system for primary osteoarthritis: short-term results of a multicenter study. J Shoulder Elbow Surg, 2018, 27(8): 1483-1490. |
28. | Werthel JD, Schoch B, Adams JE, et al. Hemiarthroplasty is an option for patients older than 70 years with glenohumeral osteoarthritis. Orthopedics, 2018, 41(4): 222-228. |
29. | Rasmussen JV, Hole R, Metlie T, et al. Anatomical total shoulder arthroplasty used for glenohumeral osteoarthritis has higher survival rates than hemiarthroplasty: a nordic registry-based study. Osteoarthritis Cartilage, 2018, 26(5): 659-665. |
30. | Levy O, Copeland SA. Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder. J Shoulder Elbow Surg, 2004, 13(3): 266-271. |
31. | Clinton J, Franta AK, Lenters TR, et al. Nonprosthetic glenoid arthroplasty with humeral hemiarthroplasty and total shoulder arthroplasty yield similar self-assessed outcomes in the management of comparable patients with glenohumeral arthritis. J Shoulder Elbow Surg, 2007, 16(5): 534-538. |
32. | Orfaly RM, Rockwood CA, Esenyel CZ, et al. A prospective functional outcome study of shoulder arthroplasty for osteoarthritis with an intact rotator cuff. J Shoulder Elbow Surg, 2003, 12(3): 214-221. |
33. | Schairer WW, Zhang AL, Feeley BT. Hospital readmissions after primary shoulder arthroplasty. J Shoulder Elbow Surg, 2014, 23(9): 1349-1355. |
34. | Edwards TB, Sabonghy EP, Elkousy H, et al. Glenoid component insertion in total shoulder arthroplasty: comparison of three techniques for drying the glenoid before cementation. J Shoulder Elbow Surg, 2007, 16(3 Suppl): S107-S110. |
35. | Throckmorton TW, Zarkadas PC, Sperling JW, et al. Pegged versus keeled glenoid components in total shoulder arthroplasty. J Shoulder Elbow Surg, 2010, 19(5): 726-733. |
36. | Lazarus MD, Jensen KL, Southworth C, et al. The radiographic evaluation of keeled and pegged glenoid component insertion. J Bone Joint Surg (Am), 2002, 84(7): 1174-1182. |
37. | Gauci MO, Bonnevialle N, Moineau G, et al. Anatomical total shoulder arthroplasty in young patients with osteoarthritis: all-polyethylene versus metal-backed glenoid. Bone Joint J, 2018, 100-B(4): 485-492. |
38. | Clitherow HD, Frampton CM, Astley TM. Effect of glenoid cementation on total shoulder arthroplasty for degenerative arthritis of the shoulder: a review of the New Zealand National Joint Registry. J Shoulder Elbow Surg, 2014, 23(6): 775-781. |
39. | Rispoli DM, Sperling JW, Athwal GS, et al. Humeral head replacement for the treatment of osteoarthritis. J Bone Joint Surg (Am), 2006, 88(12): 2637-2644. |
40. | Friedman RJ, Cheung E, Grey SG, et al. Clinical and radiographic comparison of a hybrid cage glenoid to a cemented polyethylene glenoid in anatomic total shoulder arthroplasty. J Shoulder Elbow Surg, 2019, 28(12): 2308-2316. |
41. | Nelson CG, Brolin TJ, Ford MC, et al. Five-year minimum clinical and radiographic outcomes of total shoulder arthroplasty using a hybrid glenoid component with a central porous titanium post. J Shoulder Elbow Surg, 2018, 27(8): 1462-1467. |
42. | Watson ST, Gudger GK, Long CD, et al. Outcomes of trabecular metal-backed glenoid components in anatomic total shoulder arthroplasty. J Shoulder Elbow Surg, 2018, 27(3): 493-498. |
43. | Uy M, Wang J, Horner NS, et al. Cemented humeral stem versus press-fit humeral stem in total shoulder arthroplasty: a systematic review and meta-analysis. Bone Joint J, 2019, 101-B(9): 1107-1114. |
44. | Werthel JD, Lonjon G, Jo S, et al. Long-term outcomes of cemented versus cementless humeral components in arthroplasty of the shoulder: a propensity score-matched analysis. Bone Joint J, 2017, 99-B(5): 666-673. |
45. | Lapner PL, Sabri E, Rakhra K, et al. Comparison of lesser tuberosity osteotomy to subscapularis peel in shoulder arthroplasty: a randomized controlled trial. J Bone Joint Surg (Am), 2012, 94(24): 2239-2246. |
46. | Lapner PL, Sabri E, Rakhra K, et al. Healing rates and subscapularis fatty infiltration after lesser tuberosity osteotomy versus subscapularis peel for exposure during shoulder arthroplasty. J Shoulder Elbow Surg, 2013, 22(3): 396-402. |
47. | Simone JP, Streubel PH, Sperling JW, et al. Anatomical total shoulder replacement with rotator cuff repair for osteoarthritis of the shoulder. Bone Joint J, 2014, 96-B(2): 224-228. |
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51. | Lebon J, Delclaux S, Bonnevialle N, et al. Stemmed hemiarthroplasty versus resurfacing in primary shoulder osteoarthritis: a single-center retrospective series of 78 patients. Orthop Traumatol Surg Res, 2014, 100(6 Suppl): S327-S332. |
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- 1. Singh JA, Sperling J, Buchbinder R, et al. Surgery for shoulder osteoarthritis. Cochrane Database Syst Rev, 2010, (10): CD008089. doi: 10.1002/14651858.CD008089.pub2.
- 2. Day JS, Lau E, Ong KL, et al. Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Shoulder Elbow Surg, 2010, 19(8): 1115-1120.
- 3. Bernstein DN, Keswani A, Ring D. Perioperative risk adjustment for total shoulder arthroplasty: are simple clinically driven models sufficient? Clin Orthop Relat Res, 2017, 475(12): 2867-2874.
- 4. Chalmers PN, Gupta AK, Rahman Z, et al. Predictors of early complications of total shoulder arthroplasty. J Arthroplasty, 2014, 29(4): 856-860.
- 5. Jiang JJ, Somogyi JR, Patel PB, et al. Obesity is not associated with increased short-term complications after primary total shoulder arthroplasty. Clin Orthop Relat Res, 2016, 474(3): 787-795.
- 6. Mahony GT, Werner BC, Chang B, et al. Risk factors for failing to achieve improvement after anatomic total shoulder arthroplasty for glenohumeral osteoarthritis. J Shoulder Elbow Surg, 2018, 27(6): 968-975.
- 7. Robinson WA, Wagner ER, Cofield RH, et al. Long-term outcomes of humeral head replacement for the treatment of osteoarthritis; a report of 44 arthroplasties with minimum 10-year follow-up. J Shoulder Elbow Surg, 2018, 27(5): 846-852.
- 8. Ödquist M, Hallberg K, Rahme H, et al. Lower age increases the risk of revision for stemmed and resurfacing shoulder hemi arthroplasty. Acta Orthop, 2018, 89(1): 3-9.
- 9. Rispoli DM, Sperling JW, Athwal GS, et al. Humeral head replacement for the treatment of osteoarthritis. J Bone Joint Surg (Am), 2006, 88(12): 2637-2644.
- 10. Leschinger T, Raiss P, Loew M, et al. Total shoulder arthroplasty: risk factors for intraoperative and postoperative complications in patients with primary arthritis. J Shoulder Elbow Surg, 2017, 26(3): e71-e77.
- 11. Wells DB, Holt AM, Smith RA, et al. Tobacco use predicts a more difficult episode of care after anatomic total shoulder arthroplasty. J Shoulder Elbow Surg, 2018, 27(1): 23-28.
- 12. Althoff AD, Reeves RA, Traven SA, et al. Smoking is associated with increased surgical complications following total shoulder arthroplasty: an analysis of 14, 465 patients. J Shoulder Elbow Surg, 2020, 29(3): 491-496.
- 13. Hatta T, Werthel JD, Wagner ER, et al. Effect of smoking on complications following primary shoulder arthroplasty. J Shoulder Elbow Surg, 2017, 26(1): 1-6.
- 14. Somerson JS, Neradilek MB, Service BC, et al. Clinical and radiographic outcomes of the ream-and-run procedure for primary glenohumeral arthritis. J Bone Joint Surg (Am), 2017, 99(15): 1291-1304.
- 15. Werner BC, Wong AC, Chang B, et al. Depression and patient-reported outcomes following total shoulder arthroplasty. J Bone Joint Surg (Am), 2017, 99(8): 688-695.
- 16. Blaine T, Moskowitz R, Udell J, et al. Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study. J Bone Joint Surg (Am), 2008, 90(5): 970-979.
- 17. Kwon YW, Eisenberg G, Zuckerman JD. Sodium hyaluronate for the treatment of chronic shoulder pain associated with glenohumeral osteoarthritis: a multicenter, randomized, double-blind, placebo-controlled trial. J Shoulder Elbow Surg, 2013, 22(5): 584-594.
- 18. Gartsman GM, Roddey TS, Hammerman SM. Shoulder arthroplasty with or without resurfacing of the glenoid in patients who have osteoarthritis. J Bone Joint Surg (Am), 2000, 82(1): 26-34.
- 19. Lo IK, Litchfield RB, Griffin S, et al. Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis. A prospective, randomized trial. J Bone Joint Surg (Am), 2005, 87(10): 2178-2185.
- 20. Mann T, Baumhauer JF, O’Keefe RJ, et al. High incidence of hemiarthroplasty for shoulder osteoarthritis among recently graduated orthopaedic surgeons. Clin Orthop Relat Res, 2014, 472(11): 3510-3516.
- 21. Garcia GH, Liu JN, Mahony GT, et al. Hemiarthroplasty versus total shoulder arthroplasty for shoulder osteoarthritis: a matched comparison of return to sports. Am J Sports Med, 2016, 44(6): 1417-1422.
- 22. Edwards TB, Kadakia NR, Boulahia A, et al. A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: results of a multicenter study. J Shoulder Elbow Surg, 2003, 12(3): 207-213.
- 23. Iannotti JP, Norris TR. Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg (Am), 2003, 85(2): 251-258.
- 24. Virk MS, Thorsness RJ, Griffin JW, et al. Short-term clinical outcomes of hemiarthroplasty with concentric glenoid reaming: the ream and run procedure. Orthopedics, 2018, 41(6): e854-e860.
- 25. Razmjou H, Stratford P, Kennedy D, et al. Pattern of recovery following total shoulder arthroplasty and humeral head replacement. BMC Musculoskelet Disord, 2014, 15: 306. doi: 10.1186/1471-2474-15-306.
- 26. Gowd AK, Garcia GH, Liu JN, et al. Comparative analysis of work-related outcomes in hemiarthroplasty with concentric glenoid reaming and total shoulder arthroplasty. J Shoulder Elbow Surg, 2019, 28(2): 244-251.
- 27. Krukenberg A, McBirnie J, Bartsch S, et al. Sidus stem-free shoulder system for primary osteoarthritis: short-term results of a multicenter study. J Shoulder Elbow Surg, 2018, 27(8): 1483-1490.
- 28. Werthel JD, Schoch B, Adams JE, et al. Hemiarthroplasty is an option for patients older than 70 years with glenohumeral osteoarthritis. Orthopedics, 2018, 41(4): 222-228.
- 29. Rasmussen JV, Hole R, Metlie T, et al. Anatomical total shoulder arthroplasty used for glenohumeral osteoarthritis has higher survival rates than hemiarthroplasty: a nordic registry-based study. Osteoarthritis Cartilage, 2018, 26(5): 659-665.
- 30. Levy O, Copeland SA. Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder. J Shoulder Elbow Surg, 2004, 13(3): 266-271.
- 31. Clinton J, Franta AK, Lenters TR, et al. Nonprosthetic glenoid arthroplasty with humeral hemiarthroplasty and total shoulder arthroplasty yield similar self-assessed outcomes in the management of comparable patients with glenohumeral arthritis. J Shoulder Elbow Surg, 2007, 16(5): 534-538.
- 32. Orfaly RM, Rockwood CA, Esenyel CZ, et al. A prospective functional outcome study of shoulder arthroplasty for osteoarthritis with an intact rotator cuff. J Shoulder Elbow Surg, 2003, 12(3): 214-221.
- 33. Schairer WW, Zhang AL, Feeley BT. Hospital readmissions after primary shoulder arthroplasty. J Shoulder Elbow Surg, 2014, 23(9): 1349-1355.
- 34. Edwards TB, Sabonghy EP, Elkousy H, et al. Glenoid component insertion in total shoulder arthroplasty: comparison of three techniques for drying the glenoid before cementation. J Shoulder Elbow Surg, 2007, 16(3 Suppl): S107-S110.
- 35. Throckmorton TW, Zarkadas PC, Sperling JW, et al. Pegged versus keeled glenoid components in total shoulder arthroplasty. J Shoulder Elbow Surg, 2010, 19(5): 726-733.
- 36. Lazarus MD, Jensen KL, Southworth C, et al. The radiographic evaluation of keeled and pegged glenoid component insertion. J Bone Joint Surg (Am), 2002, 84(7): 1174-1182.
- 37. Gauci MO, Bonnevialle N, Moineau G, et al. Anatomical total shoulder arthroplasty in young patients with osteoarthritis: all-polyethylene versus metal-backed glenoid. Bone Joint J, 2018, 100-B(4): 485-492.
- 38. Clitherow HD, Frampton CM, Astley TM. Effect of glenoid cementation on total shoulder arthroplasty for degenerative arthritis of the shoulder: a review of the New Zealand National Joint Registry. J Shoulder Elbow Surg, 2014, 23(6): 775-781.
- 39. Rispoli DM, Sperling JW, Athwal GS, et al. Humeral head replacement for the treatment of osteoarthritis. J Bone Joint Surg (Am), 2006, 88(12): 2637-2644.
- 40. Friedman RJ, Cheung E, Grey SG, et al. Clinical and radiographic comparison of a hybrid cage glenoid to a cemented polyethylene glenoid in anatomic total shoulder arthroplasty. J Shoulder Elbow Surg, 2019, 28(12): 2308-2316.
- 41. Nelson CG, Brolin TJ, Ford MC, et al. Five-year minimum clinical and radiographic outcomes of total shoulder arthroplasty using a hybrid glenoid component with a central porous titanium post. J Shoulder Elbow Surg, 2018, 27(8): 1462-1467.
- 42. Watson ST, Gudger GK, Long CD, et al. Outcomes of trabecular metal-backed glenoid components in anatomic total shoulder arthroplasty. J Shoulder Elbow Surg, 2018, 27(3): 493-498.
- 43. Uy M, Wang J, Horner NS, et al. Cemented humeral stem versus press-fit humeral stem in total shoulder arthroplasty: a systematic review and meta-analysis. Bone Joint J, 2019, 101-B(9): 1107-1114.
- 44. Werthel JD, Lonjon G, Jo S, et al. Long-term outcomes of cemented versus cementless humeral components in arthroplasty of the shoulder: a propensity score-matched analysis. Bone Joint J, 2017, 99-B(5): 666-673.
- 45. Lapner PL, Sabri E, Rakhra K, et al. Comparison of lesser tuberosity osteotomy to subscapularis peel in shoulder arthroplasty: a randomized controlled trial. J Bone Joint Surg (Am), 2012, 94(24): 2239-2246.
- 46. Lapner PL, Sabri E, Rakhra K, et al. Healing rates and subscapularis fatty infiltration after lesser tuberosity osteotomy versus subscapularis peel for exposure during shoulder arthroplasty. J Shoulder Elbow Surg, 2013, 22(3): 396-402.
- 47. Simone JP, Streubel PH, Sperling JW, et al. Anatomical total shoulder replacement with rotator cuff repair for osteoarthritis of the shoulder. Bone Joint J, 2014, 96-B(2): 224-228.
- 48. Iannotti JP, Norris TR. Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg (Am), 2003, 85(2): 251-258.
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