Primary Glenohumeral Osteoarthritis

Glenohumeral osteoarthritis (OA) is a gradual, progressive, mechanical, and biochemical breakdown of the articular cartilage, bone, and joint capsule of the shoulder. This painful condition is a growing problem in the aging population. In most cases, diagnosis of degenerative joint disease of the shoulder can be made with careful history, physical examination, and complementary images. Radiographs are essential to diagnosing and staging glenohumeral OA. Preoperative 3D CT is a useful tool to analyze glenoid version and inclination more accurately, the severity and location of glenoid bone loss, as well as the assessment of preoperative planning. General nonsurgical modalities, including changes in daily activities, physical therapy, pharmacotherapy, and corticosteroid injections constitute the mainstay of initial treatment. Pain and disability associated with mild to severe radiological degenerative changes in the glenohumeral joint are almost always the indications for surgical intervention in patients with glenohumeral OA when nonoperative treatment has failed. This chapter will provide an overview of evaluation and management of glenohumeral OA.