Monday, October 31, 2016

Reverse total shoulder for irreparable cuff tear

Here's an example of a reverse total shoulder for pseudoparalysis from an irreparable cuff tear in a 78 year old man. At the time of presentation he could perform only 3 of the 12 functions of the simple shoulder test.
The preoperative MRI and plain films show the absence of glenohumeral arthritis.

He elected a reverse total shoulder which was performed with an impaction auto grafted mono block humeral prosthesis and a laterally offset glenosphere positioned without inferior angulation and with immediate secure screw fixation to the glenoid bone.

At three months after surgery he has a comfortable shoulder with 100 degrees of active motion and steadily improving function.

Comment: This case represents our effort to move to a more anatomical reconstruction using the reverse, emphasizing less lengthening of the arm and more East-West tensioning and biological fixation of a single piece stem without cement or bony ingrowth.