TSA Techniques in Glenohumeral OA

Patient Population The target population is both men and women of any age with advanced osteoarthritis of the glenohumeral joint who are considered by the treating surgeon to be a candidate for shoulder replacement. The type of arthritic process will not be considered a deciding factor. The arthritis must be amenable to treatment using either a humeral head replacement (stemmed or stem-less), or a standard total shoulder replacement. Inclusion Criteria 1. Patients who have failed standard non-surgical management of their shoulder osteoarthritis who would benefit from a shoulder arthroplasty. Failed medical management will be defined as persistent pain and disability despite adequate standard non-operative management for 6 months. Medical management will be defined as: 1. The use of drugs including analgesics and non-steroidal anti-inflammatory drugs 2. Physiotherapy consisting of stretching, strengthening and local modalities (ultrasound, cryotherapy, etc.) 3. Activity modification 2. Patients will present with a glenoid retroversion between 10-26 degrees. 3. Imaging, and intra-operative findings confirming advanced humeral head cartilage loss, with or without glenoid cartilage loss. 4. Age 18 years or older Exclusion Criteria 1. \< 10 degrees / \> 27 degrees of glenoid retroversion 2. Active joint or systemic infection 3. Rotator cuff arthropathy 4. Significant muscle paralysis 5. Charcot's arthropathy 6. Major medical illness (life expectancy less than 1 year or unacceptably high operative risk) 7. Unable to understand the consent form/process 8. Pregnancy 9. Psychiatric illness that precludes informed consent 10. Unwilling to be followed for the duration of the study 11. Retroversion cannot be surgically corrected to within 10 degrees of neutral 12. History of previous shoulder surgery on affected side 13. Rheumatoid arthritis in the affected shoulder