It is well recognized that female sex, osteopenia, rotator cuff tear arthropathy, inflammatory joint disease and thin acromial bone are risk factors for acromial and scapular spine fractures after reverse total shoulder arthroplasty. Unfortunately, these conditions are commonly encountered in shoulder surgery.
A 71 year old woman presented with all of these conditions, retained active elevation above 90 degrees, and answered "yes" to only 3 functions of the 12 Simple Shoulder Test questions.
Her right shoulder x-ray at the time of presentation is shown below, demonstrating a thinned acromion, osteopenia, and acromiohumeral contact.
After discussion of the surgical options, including a reverse total shoulder, she elected to proceed with a CTA hemiarthroplasty. At the time of surgery, her supraspinatus and infraspinatus were detached and irreparable. Her subscapularis was detached but reparable.
A thin humeral stem was inserted with impaction autografting to provide a small filling ratio.
Nine years later she returned for evaluation of her contralateral shoulder.
Her CTA hemiarthroplasty shoulder had 140 degrees of comfortable active elevation.
Her nine year followup film is shown below, demonstrating an intact acromion and no evidence of component loosening.
Comment: In our experience patients selected for the CTA hemiarthroplasty have been free of acromial/scapular spine fractures, dislocations, and prosthetic loosening. See CTA hemiartroplasty or reverse total shoulder for cuff tear arthropathy.
Comments welcome at shoulderarthritis@uw.edu
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/X: https://x.com/RickMatsen
Follow on facebook: https://www.facebook.com/shoulder.arthritis
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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/X: https://x.com/RickMatsen
Follow on facebook: https://www.facebook.com/shoulder.arthritis
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).
