Decision making in cuff tear arthropathy

Here are the x-rays of a lady who, in spite of her age of 86 years, works actively on a large farm with her husband. Note the femoralization of the proximal humerus and the acetabularization of the glenoid-coracoacromial socket. She had active elevation to 90 degrees without instability, but it was quite painful for her. She desired shoulder reconstruction. What would you choose for her?

Wishing to avoid the activity limitations of a reverse total shoulder, she elected to have a CTA arthroplasty. Here are her films at 6 weeks - at that time she had minimal discomfort and was diligently working on her active elevation.

Stay tuned for the result.
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