The effectiveness of physiotherapy-led non-surgical and perioperative interventions for glenohumeral osteoarthritis: A systematic review

Background Physiotherapists are commonly involved in the management of adults with glenohumeral osteoarthritis (GHOA), to improve symptoms or restore function after surgery. This systematic review investigated the effectiveness of physiotherapist-led interventions in adults with GHOA including rotator cuff arthropathy (RCA). Method We conducted a comprehensive systematic review (PROSPERO Registration : CRD42022318534) searching PubMed, Cochrane, CINAHL, EMBASE and PEDro databases from inception up until June 2025. Articles were included if they were randomised controlled trials (RCTs) involving adults aged ≥45 years with GHOA including RCA across non-surgical and perioperative settings where interventions were led by physiotherapists and articles reported pain or functional outcomes, or adverse events. Results were narratively synthesised. Results Of 582 articles identified, four RCTs were eligible and included in the review. Each focussed on postoperative physiotherapist-led interventions and none were placebo-controlled. Low-certainty evidence showed no between-group differences in patient outcomes at any time point between postoperative physiotherapist-led interventions delivered early (within the first 6 weeks) versus delayed interventions delivered after 6 weeks. Evidence from the remaining findings of this review is of very low certainty. Conclusion The evidence base about the effectiveness of physiotherapist-led interventions for GHOA and RCA is extremely limited and of poor quality. No published RCTs have evaluated physiotherapist-led interventions for patients with GHOA undergoing non-surgical care. High-quality, adequately powered RCTs are required to determine effectiveness of physiotherapist-led interventions for GHOA and RCA and inform evidence-based care.