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Glenohumeral Joint Osteoarthritis A Guide for Physical Therapists

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Recommendations Nonoperative   ➤ Physical therapist services may benefit patients with glenohumeral joint osteoarthritis who have not undergone total shoulder arthroplasty. ★★★★ Preoperative   ➤ History, physical exam, and radiographs can be useful to differentially diagnose GHOA. Specifically, critical shoulder angle on radiographs and age is predictive of the diagnosis. ★★★★   ➤ Advanced imaging of magnetic resonance imaging is beneficial in the differential diagnosis of GHOA. MRI is helpful to confirm the diagnosis but is less useful to rule out the diagnosis. ★★★★   ➤ In the absence of reliable evidence, the opinion of the Guideline Development Group is that physical therapist services delivered preoperatively may benefit postoperative outcomes in patients with GHOA who are undergoing TSA. ★★★★ Postoperative   ➤ Physical therapist services delivered postoperatively may benefit patient-rated functional outcomes in the management of patients who have undergone TSA for GHOA. ★★★★   ➤ Physical therapists should implement the use of a sling with the shoulder in a neutral position and progressive exercises for range of motion (ROM) and strengthening to improve patient-reported outcomes and ROM in patients with GHOA who have undergone TSA. ★★★★   ➤ Physical therapists should implement the use of a sling with the shoulder in a neutral position for pain management in patients with GHOA who have undergone TSA. ★★★★   ➤ No one specific intervention is superior to another for patients with GHOA. ★★★★   ➤ The timing of the introduction of shoulder ROM exercises by physical therapists may be delayed up to 4 weeks without negatively impacting patient-reported outcomes in patients with GHOA who have undergone TSA. ★★★★   ➤ Interventions for edema in patients with GHOA who have undergone TSA should be based on best available evidence, clinical expertise, and patient values. ★★★★

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