A Brief Review of Reverse Shoulder Arthroplasty for Rotator Cuff Arthropathy

Reverse total shoulder arthroplasty is an increasingly popular procedure performed by orthopedic surgeons. The indications have expanded over the past two decades with well documented success in the treatment of rotator cuff arthropathy. Patients with loss of rotator cuff function experience altered shoulder biomechanics that lead to superior humeral head migration, acetabulization of the acromion and progressive glenohumeral arthritis. Clinically, patients present with chronic shoulder pain, weakness and loss of range of motion that impacts activities of daily living. To address this, a reverse total shoulder can be performed. The procedure is normally done in the beach chair position utilizing the deltopectoral approach. A humeral stem with liner and glenosphere is implanted into the humerus and scapula, respectively. The procedure has shown consistent improvements in pain, strength, range-of-motion and function. Complications include dislocation, instability, fracture and infection.

Keywords: Rotator cuff arthropathy; Reverse total shoulder arthroplasty; Arthritis, Shoulder; Shoulder replacement; Review

Abbreviations:

TSA – Total shoulder arthroplasty

RTSA - Reverse total shoulder arthroplasty

CTA - Cuff tear arthropathy

RCR - Rotator cuff repair

AHI - Acromiohumeral index

MMI - Maximum medical improvement

ER - External rotation

ROM - Range of motion