Four of the six authors of this paper received payments from the company making a reverse total shoulder (RSA) and the study was funded by this company.
Comment: Recognizing that patients needing reverse shoulder arthroplasty have reduced use of their shoulders prior to surgery with resulting disuse atrophy of the bone. This may be superimposed on osteoporosis, in that many patients are elderly females (over 80% in this report). The reverse total shoulder enables a sudden and dramatic increase in the loads applied to the scapular and also has the potential to weaken it with screw placement. These loads are increased if the deltoid is put under a lot of tension by distal translation of the shoulder. Additional loading may result from the patient's beginning to use the shoulder for assistance in rising from a chair or from use of walker, cane or crutch.
Our practice is to advise patients of the risk of these fractures and to recommend a very gradual increase in arm use after RSA, especially in the presence of osteoporosis. If the patient presents with scapular pain at any time after this procedure, we find that clinical examination for scapular spine or acromial tenderness is very sensitive, perhaps more sensitive that imaging. These patients are advised to reduce activities while we monitor their progress.
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Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.