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

Background: It is not always clear how to treat glenohumeral osteoarthritis, particularly in young patients. The goals ofthis study were to 1) quantify how patient age, activity level, symptoms, and radiographic findings impact the decisionmakingof shoulder specialists and 2) evaluate the observer reliability of the Kellgren-Lawrence (KL) grading system forprimary osteoarthritis of the shoulder.Methods: Twenty-six shoulder surgeons were each sent 54 simulated patient cases. Each patient had a differentcombination of age, symptoms, activity level, and radiographs. Responders graded the radiographs and chose atreatment (non-operative, arthroscopy, hemiarthroplasty, or total shoulder arthroplasty). Spearman correlations andchi square tests were used to assess the relationship between factors and treatments. Sub-analysis was performedon surgical cases. An intra-class correlation (ICC) was used to assess observer agreement.Results: The significant correlations (P