Treatment of glenohumeral osteoarthritis.
This clinical practice guideline is based on a systematic review of published studies on the treatment of glenohumeral osteoarthritis in the adult patient population. Of the 16 recommendations addressed, nine are inconclusive. Two were reached by consensus-that physicians use perioperative mechanical and/or chemical venous thromboembolism prophylaxis for shoulder arthroplasty patients and that total shoulder arthroplasty not be performed in patients with glenohumeral osteoarthritis who have an irreparable rotator cuff tear. Four options were graded as weak: the use of injectable viscosupplementation; total shoulder arthroplasty and hemiarthroplasty as treatment; avoiding shoulder arthroplasty by surgeons who perform fewer than two shoulder arthroplasties per year (to reduce the risk of immediate postoperative complications); and the use of keeled or pegged all-polyethylene cemented glenoid components. The single moderate-rated recommendation was for the use of total shoulder arthroplasty rather than hemiarthroplasty. Management of glenohumeral osteoarthritis remains controversial; the scientific evidence on this topic can be significantly improved.
Izquierdo
Rolando
R
Voloshin
Ilya
I
Edwards
Sara
S
Freehill
Michael Q
MQ
Stanwood
Walter
W
Wiater
J Michael
JM
Watters
William C
WC
Goldberg
Michael J
MJ
Keith
Michael
M
Turkelson
Charles M
CM
Wies
Janet L
JL
Anderson
Sara
S
Boyer
Kevin
K
Raymond
Laura
L
Sluka
Patrick
P
D000925:Anticoagulants / Q000008:administration & dosage; D019643:Arthroplasty, Replacement / Q000379:methods*; D000075202:Contraindications; D006801:Humans; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants