Reverse total shoulder - how much activity is appropriate?

A healthy, active patient in her early sixties had a cuff repair 19 years ago, which failed. Then 10 years ago had an attempt at a revision of her cuff repair. She presented with pseuoparalysis and these x-rays.

A reverse total shoulder arthroplasty was performed. Here is the post op AP x-ray.

Two months post surgery, the x-ray appearance was stable

 Six months after surgery, she increased her physical activity, including gym workouts. X-rays at that time are shown below, with no evidence of problem

Two and a half years after surgery, the shoulder felt fine, but there was evidence of bone resorption beneath the baseplate.

Four and a half years after surgery, the shoulder felt fine, but there was increase bone respiration beneath the baseplate

There was no evidence of a problem on the axillary view

At five years after surgery and after a vigorous gym workout she presented with pain over the back of her scapular spine and these x-rays.

The axillary view shows a crack in the spine of the scapula (C)

Comment: This case brings up the question of the degree to which activities should be limited after a reverse arthroplasty


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