Bull Hosp Jt Dis (2013). 2022 Mar;80(1):37-46.
Glenohumeral osteoarthritis (GHOA) in the young adult remains a challenging clinical problem to treat. These difficulties stem from the high physical demands and expectations of this patient population, limited longevity of existing treatment modalities, and need for a future revision surgery after primary surgical intervention. Given the heterogeneous etiology, clinical presentation, and radiographic findings, a thorough understanding of the pathology, patient expectations, and outcomes of existing treatment options available is necessary to deliver a treatment that is tailored to individual needs of the patient. None of the available treatment options have shown to alter the natural history of GHOA. Nonsurgical modalities continue to be the first line treatment but there is no consensus if one treatment is more effective than the other. Surgical options include shoulder preserving and shoulder replacing procedures and are usually considered after the nonsurgical options become ineffective in controlling a patient's symptoms. Total shoulder arthroplasty provides predictable pain relief and improvement of function but is limited by the longevity of the implant. Despite the growing research, there continues to be search for a long lasting, durable treatment option that would compete with a young adult's lifetime.
肩盂肱关节炎（GHOA）在年轻成人中仍然是一个具有挑战性的临床治疗问题。这些困难源于该患者群体的高生理需求和期望、现有治疗方式的寿命有限，以及初次手术干预后的未来翻修手术的需求。鉴于其病因、临床表现和影像学结果的异质性，需要全面了解病理、患者预期和现有治疗选择的结果，以便提供针对患者个体需求的治疗方案。目前尚无任何治疗选择被证明可以改变 GHOA 的自然病程。非手术治疗仍然是一线治疗方法，但目前尚无共识确定哪种治疗方法更有效。手术治疗包括保留肩袖和置换肩袖的手术，通常在非手术治疗方法无法有效控制患者症状后才会考虑。全肩关节置换术可提供可预测的疼痛缓解和功能改善，但受植入物寿命的限制。尽管研究不断增加，但仍在寻找一种持久、耐用的治疗方法，以与年轻成人的一生相竞争。
