A 60 year old physically active electrician sustained a traumatic cuff tear in the right shoulder, which was repaired 16 years prior to presentation. The function of the shoulder deteriorated progressively to the point that he was unable to return to work or his other activities. A series of PRP injections appeared to worsen his symptoms. Another surgeon offered a reverse total shoulder but the patient declined out of concern for complications and failure of the polyethylene liner with his hobbies of chopping wood and bee keeping.
At the time of presentation he had a painful crepitant shoulder with only 70 degrees of active elevation and 140 degrees of passive motion. He had weakness of elevation and external rotation, but strong internal rotation.
His radiographs showed glenohumeral arthritis and retained suture anchors.
After a discussion of the alternatives, he desired to proceed with a CTA hemiarthroplasty (see this link). At surgery his supraspinatus and infraspinatus were torn and irreparable. His subscapularis was intact.
His postoperative radiograph is shown below.
Three months after surgery he returned to work as an electrician with a comfortable functional shoulder. His active elevation at 3 months is shown below
He had no limitation of active internal rotation (which can be a problem after reverse total shoulder arthroplasty).
Comment: While this man did not meet the usual criteria for a cuff tear arthropathy hemiarthroplasty (preoperative active elevation >90 degrees with good passive elevation), his strong rehabilitation efforts enabled him to regain the function he needed for work
The chart below shows the minimum two year followup data for 45 patients having CTA hemiarthroplasty for cuff tear arthropathy with retained active elevation.
None of these patients experienced the complications that can be associated with reverse total shoulder arthroplasty (e.g. dislocation, notching, acromial/spine fracture).
None of these patients experienced the complications that can be associated with reverse total shoulder arthroplasty (e.g. dislocation, notching, acromial/spine fracture).
See these related posts:
Reverse total shoulder for everything? How about for cuff tear arthropathy?
Mechanical failure of reverse shoulder arthroplasty
You can support cutting edge shoulder research that is leading to better care for patients with shoulder problems, click on this link.
Follow on twitter: https://twitter.com/shoulderarth
Follow on facebook: click on this link
Follow on facebook: https://www.facebook.com/frederick.matsen
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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).
You can support cutting edge shoulder research that is leading to better care for patients with shoulder problems, click on this link.
Follow on twitter: https://twitter.com/shoulderarth
Follow on facebook: click on this link
Follow on facebook: https://www.facebook.com/frederick.matsen
Follow on LinkedIn: https://www.linkedin.com/in/rick-matsen-88b1a8133/
Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).
