When nonoperative management for glenohumeral joint osteoarthritis fails, what is the next recommended treatment?

When nonoperative management for glenohumeral joint osteoarthritis fails, what is the next recommended treatment?

• A. Total Shoulder Arthroplasty
• B. Continued physical therapy for years
• C. Arthroscopic debridement
• D. Corticosteroid injections only

Answer: (A)

Once nonoperative strategies fail to control symptoms from glenohumeral joint osteoarthritis, surgical joint replacement becomes the next step. Total shoulder arthroplasty is the preferred option when the rotator cuff is intact because it replaces the worn joint surfaces of both the humeral head and the glenoid, providing durable pain relief and improved function. Nonoperative treatments—like ongoing physical therapy or corticosteroid injections—can help with symptoms but do not correct the degenerative joint surfaces, and arthroscopic debridement has limited benefit in established OA. If a massive rotator cuff tear is present, a reverse total shoulder may be considered, but in the typical OA patient without cuff pathology, the total shoulder arthroplasty is the recommended next treatment.

Once nonoperative strategies fail to control symptoms from glenohumeral joint osteoarthritis, surgical joint replacement becomes the next step. Total shoulder arthroplasty is the preferred option when the rotator cuff is intact because it replaces the worn joint surfaces of both the humeral head and the glenoid, providing durable pain relief and improved function. Nonoperative treatments—like ongoing physical therapy or corticosteroid injections—can help with symptoms but do not correct the degenerative joint surfaces, and arthroscopic debridement has limited benefit in established OA. If a massive rotator cuff tear is present, a reverse total shoulder may be considered, but in the typical OA patient without cuff pathology, the total shoulder arthroplasty is the recommended next treatment.