<?xml version="1.0" encoding="utf-8"?>
			<journal>
			<title>The Archives of Bone and Joint Surgery</title>
			<title_fa></title_fa>
			<short_title>ABJS</short_title>
			<subject>Medical Sciences</subject>
			<web_url>https://abjs.mums.ac.ir/</web_url>
			<journal_hbi_system_id>0</journal_hbi_system_id>
			<journal_hbi_system_user></journal_hbi_system_user>
			<journal_id_issn>2345-4644</journal_id_issn>
			<journal_id_issn_online>2345-461X</journal_id_issn_online>
			<journal_id_pii></journal_id_pii>
			<journal_id_doi></journal_id_doi>
			<journal_id_iranmedex></journal_id_iranmedex>
			<journal_id_magiran></journal_id_magiran>
			<journal_id_sid></journal_id_sid>
			<journal_id_nlai></journal_id_nlai>
			<journal_id_science></journal_id_science>
			<language>en</language>
			<pubdate>
				<type>jalali</type>
				<year>0</year>
				<month>0</month>
				<day>1</day>
			</pubdate>
			<pubdate>
				<type>gregorian</type>
				<year>2019</year>
				<month>3</month>
				<day>1</day>
			</pubdate>
			<volume>7</volume>
			<number>2</number>
			<publish_type>online</publish_type>
			<publish_edition>1</publish_edition>
			<article_type>fulltext</article_type>
			<articleset><article>
				<language>en</language>
				<article_id_issn></article_id_issn>
				<article_id_issn_online></article_id_issn_online>
				<article_id_pubmed></article_id_pubmed>
				<article_id_pii></article_id_pii>
				<article_id_doi></article_id_doi>
				<article_id_iranmedex></article_id_iranmedex>
				<article_id_magiran></article_id_magiran>
				<article_id_sid></article_id_sid>
				<title_fa></title_fa>
				<title>Evaluating Glenohumeral Osteoarthritis: The Relative Impact of Patient Age, Activity Level, Symptoms, and Kellgren-Lawrence Grade on Treatment</title>
				<subject_fa></subject_fa>
				<subject></subject>
				<content_type_fa></content_type_fa>
				<content_type>RESEARCH PAPER</content_type>
				<abstract_fa><![CDATA[]]></abstract_fa>
				<abstract><![CDATA[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&lt;0.01) were: symptoms [0.46], KL grade [0.44], and age [0.11]. In the subanalysisof 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&lt;0.01) for all factors, but the practical significance of activity level wasminimal. 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 moststrongly associated with treatment. In operative cases, the factors most strongly associated with the choice of operationwere 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 thisremains a controversial topic.Level of evidence: III]]></abstract>
				<keyword_fa></keyword_fa>
				<keyword>Clinical Decision-Making, Glenohumeral Osteoarthritis, Hemiarthroplasty, Kellgren-Lawrence, Patient Factors, Total Shoulder Arthroplasty</keyword>
				<start_page>151</start_page>
				<end_page>160</end_page>
				<web_url>https://abjs.mums.ac.ir/article_11643.html</web_url>
			<author_list><author>
				<first_name>Adam</first_name>
				<middle_name></middle_name>
				<last_name>Schumaier</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>adam.schumaier@uc.edu</email>
				<code>49063</code>
				<coreauthor>Yes</coreauthor>
				<affiliation>University of Cincinnati Department of Orthopaedics and
Sports Medicine, Cincinnati, Ohio, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Joseph</first_name>
				<middle_name></middle_name>
				<last_name>Abboud</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>abboudj@gmail.com</email>
				<code>49064</code>
				<coreauthor>No</coreauthor>
				<affiliation>Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Brian</first_name>
				<middle_name></middle_name>
				<last_name>Grawe</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>grawebn@ucmail.uc.edu</email>
				<code>49065</code>
				<coreauthor>No</coreauthor>
				<affiliation>University of Cincinnati Department of Orthopaedics and
Sports Medicine, Cincinnati, Ohio, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>J. Gabriel</first_name>
				<middle_name></middle_name>
				<last_name>Horneff</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52295</code>
				<coreauthor>No</coreauthor>
				<affiliation>Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Charles</first_name>
				<middle_name></middle_name>
				<last_name>Getz</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>charles.getz@rothmaninsitute.com</email>
				<code>52296</code>
				<coreauthor>No</coreauthor>
				<affiliation>Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Gerald</first_name>
				<middle_name></middle_name>
				<last_name>Williams</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>grwjr@me.com</email>
				<code>52297</code>
				<coreauthor>No</coreauthor>
				<affiliation>Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Matthew</first_name>
				<middle_name></middle_name>
				<last_name>Ramsey</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>matthew.ramsey@rothmaninsitute.com</email>
				<code>52298</code>
				<coreauthor>No</coreauthor>
				<affiliation>Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Surena</first_name>
				<middle_name></middle_name>
				<last_name>Namdari</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>surena.namdari@gmail.com</email>
				<code>52299</code>
				<coreauthor>No</coreauthor>
				<affiliation>Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Anthony</first_name>
				<middle_name></middle_name>
				<last_name>Romeo</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52300</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Rush University
Medical Center, Chicago, Illinois, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Gregory</first_name>
				<middle_name></middle_name>
				<last_name>Nicholson</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52301</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Rush University
Medical Center, Chicago, Illinois, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Jay</first_name>
				<middle_name></middle_name>
				<last_name>Keener</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52302</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Richard</first_name>
				<middle_name></middle_name>
				<last_name>Friedman</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52303</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Medical
University of South Carolina, Charleston, South
Carolina, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Ed</first_name>
				<middle_name></middle_name>
				<last_name>Yian</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52304</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedics, Southern California
Permanente Medical Group, Anaheim, California, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Stephanie</first_name>
				<middle_name></middle_name>
				<last_name>Muh</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52305</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Henry Ford Hospital,
Detroit, Michigan, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Ruth</first_name>
				<middle_name></middle_name>
				<last_name>Delaney</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52306</code>
				<coreauthor>No</coreauthor>
				<affiliation>University College Dublin, Dublin, Ireland</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Randall</first_name>
				<middle_name></middle_name>
				<last_name>Otto</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52307</code>
				<coreauthor>No</coreauthor>
				<affiliation>Premier Care Orthopaedics and Sports Medicine, St.
Louis, Missouri, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>William</first_name>
				<middle_name></middle_name>
				<last_name>Levine</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52308</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Columbia University
Medical Center, New York, New York, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>JT</first_name>
				<middle_name></middle_name>
				<last_name>Tokish</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52309</code>
				<coreauthor>No</coreauthor>
				<affiliation>Steadman Hawkins Clinic of the Carolinas, Greenville
Health System, Greenville, South Carolina, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Jack</first_name>
				<middle_name></middle_name>
				<last_name>Kazanjian</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52310</code>
				<coreauthor>No</coreauthor>
				<affiliation>Premier Orthopaedics, Havertown, Pennsylvania, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Joshua</first_name>
				<middle_name></middle_name>
				<last_name>Dines</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52311</code>
				<coreauthor>No</coreauthor>
				<affiliation>Hospital for Special Surgery, New York, New York, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Andrew</first_name>
				<middle_name></middle_name>
				<last_name>Green</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52320</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Warren-Alpert
School of Medicine at Brown University, Providence,
Rhode Island</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Scott</first_name>
				<middle_name></middle_name>
				<last_name>Paxton</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>escottpaxton@gmail.com</email>
				<code>52321</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Warren-Alpert
School of Medicine at Brown University, Providence,
Rhode Island</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Brody</first_name>
				<middle_name></middle_name>
				<last_name>Flanagin</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52322</code>
				<coreauthor>No</coreauthor>
				<affiliation>Orthopaedic Associates of Dallas, Dallas, Texas, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Samer</first_name>
				<middle_name></middle_name>
				<last_name>Hasan</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52323</code>
				<coreauthor>No</coreauthor>
				<affiliation>Cincinnati Sports Medicine, Cincinnati, Ohio, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Scott</first_name>
				<middle_name></middle_name>
				<last_name>Kaar</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52324</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Saint Louis
University, St. Louis, Missouri, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Anthony</first_name>
				<middle_name></middle_name>
				<last_name>Miniaci</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52325</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Cleveland Clinic,
Cleveland, Ohio, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Frances</first_name>
				<middle_name></middle_name>
				<last_name>Cuomo</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email></email>
				<code>52326</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Orthopaedic Surgery, Montefiore, New
York, New York, USA</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author></author_list>
				</article>
			</articleset>
			</journal>