Evaluating Glenohumeral Osteoarthritis: The Relative Impact of Patient Age, Activity Level, Symptoms, and Kellgren-Lawrence Grade on Treatment

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Schumaier Adam; Abboud Joseph; Grawe Brian; Horneff J.Gabriel; Getz Charles; Romeo Anthony; Keener Jay; Friedman Richard; Yian Ed; Muh Stephanie; Nicholson Gregory; Delaney Ruth; Otto Randall; Levine William; Tokish J.T.; Williams Gerald; Kazanjian Jack; Dines Joshua; Ramsey Matthew; Green Andrew; Paxton Scott; Namdari Surena; Flanagin Brody; Hasan Samer; Kaar Scott; Miniaci Anthony; Cuomo Frances

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Journal Paper

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Journal: Archives of Bone and Joint Surgery Year:2019 | Volume:7 | Issue:2 Page(s): 151-160

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Title

Evaluating Glenohumeral Osteoarthritis: The Relative Impact of Patient Age, Activity Level, Symptoms, and Kellgren-Lawrence Grade on Treatment

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Keywords

Clinical decision-making

Glenohumeral osteoarthritis

Hemiarthroplasty

Kellgren-lawrence

Patient factors

Total shoulder arthroplasty

Abstract

Background: It is not always clear how to treat Glenohumeral osteoarthritis, particularly in young patients. The goals of this study were to 1) quantify how patient age, activity level, symptoms, and radiographic findings impact the decisionmaking of shoulder specialists and 2) evaluate the observer reliability of the Kellgren-lawrence (KL) grading system for primary osteoarthritis of the shoulder. Methods: Twenty-six shoulder surgeons were each sent 54 simulated patient cases. Each patient had a different combination of age, symptoms, activity level, and radiographs. Responders graded the radiographs and chose a treatment (non-operative, arthroscopy, Hemiarthroplasty, or Total shoulder arthroplasty). Spearman correlations and chi square tests were used to assess the relationship between factors and treatments. Sub-analysis was performed on surgical cases. An intra-class correlation (ICC) was used to assess observer agreement. Results: The significant correlations (P<0. 01) were: symptoms [0. 46], KL grade [0. 44], and age [0. 11]. In the subanalysis of operative cases, the significant correlations were: KL grade [0. 64], age [0. 39], and activity level [-0. 10]. The chi square analysis was significant (P<0. 01) for all factors, but the practical significance of activity level was minimal. The ICCs were [inter](intra): KL [0. 79] (0. 84), patient management [0. 54]. Conclusion: When evaluating Glenohumeral osteoarthritis, patient symptoms and KL grade are the factors most strongly associated with treatment. In operative cases, the factors most strongly associated with the choice of operation were the patient’ s KL grade and age. Additionally, the KL classification demonstrated excellent observer reliability. However, there was only moderate agreement among shoulder specialists regarding treatment, indicating that this remains a controversial topic.

Cites

Comparison of Asymmetric Reaming versus a Posteriorly Augmented Component for Posterior Glenoid Wear and Retroversion: A Radiographic Study

References

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APA: Copy

Schumaier, Adam, Abboud, Joseph, Grawe, Brian, Horneff, J.Gabriel, Getz, Charles, Romeo, Anthony, Keener, Jay, Friedman, Richard, Yian, Ed, Muh, Stephanie, Nicholson, Gregory, Delaney, Ruth, Otto, Randall, Levine, William, Tokish, J.T., Williams, Gerald, Kazanjian, Jack, Dines, Joshua, Ramsey, Matthew, Green, Andrew, Paxton, Scott, Namdari, Surena, Flanagin, Brody, Hasan, Samer, Kaar, Scott, Miniaci, Anthony, & Cuomo, Frances. (2019). Evaluating Glenohumeral Osteoarthritis: The Relative Impact of Patient Age, Activity Level, Symptoms, and Kellgren-Lawrence Grade on Treatment. THE ARCHIVES OF BONE AND JOINT SURGERY, 7(2), 151-160. SID. https://sid.ir/paper/746704/en

Vancouver: Copy

Schumaier Adam, Abboud Joseph, Grawe Brian, Horneff J.Gabriel, Getz Charles, Romeo Anthony, Keener Jay, Friedman Richard, Yian Ed, Muh Stephanie, Nicholson Gregory, Delaney Ruth, Otto Randall, Levine William, Tokish J.T., Williams Gerald, Kazanjian Jack, Dines Joshua, Ramsey Matthew, Green Andrew, Paxton Scott, Namdari Surena, Flanagin Brody, Hasan Samer, Kaar Scott, Miniaci Anthony, Cuomo Frances. Evaluating Glenohumeral Osteoarthritis: The Relative Impact of Patient Age, Activity Level, Symptoms, and Kellgren-Lawrence Grade on Treatment. THE ARCHIVES OF BONE AND JOINT SURGERY[Internet]. 2019;7(2):151-160. Available from: https://sid.ir/paper/746704/en

IEEE: Copy

Adam Schumaier, Joseph Abboud, Brian Grawe, J.Gabriel Horneff, Charles Getz, Anthony Romeo, Jay Keener, Richard Friedman, Ed Yian, Stephanie Muh, Gregory Nicholson, Ruth Delaney, Randall Otto, William Levine, J.T. Tokish, Gerald Williams, Jack Kazanjian, Joshua Dines, Matthew Ramsey, Andrew Green, Scott Paxton, Surena Namdari, Brody Flanagin, Samer Hasan, Scott Kaar, Anthony Miniaci, and Frances Cuomo, “Evaluating Glenohumeral Osteoarthritis: The Relative Impact of Patient Age, Activity Level, Symptoms, and Kellgren-Lawrence Grade on Treatment,” THE ARCHIVES OF BONE AND JOINT SURGERY, vol. 7, no. 2, pp. 151–160, 2019, [Online]. Available: https://sid.ir/paper/746704/en

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