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.
★★★★
