extends under baseplate approaching central peg
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Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC.
A 75-year-old male with 2 previous rotator cuff repairs has persistent shoulder pain and active forward elevation to 60 degrees. He has normal deltoid function with a positive lift-off test. Radiographs and coronal MRI of his shoulder are found in Figures A through C. Which of the following treatment options is most appropriate?
Revision supraspinatus repair
Total shoulder arthroplasty
Reverse total shoulder arthroplasty
Select Answer to see Preferred Response
Deltoid denervation is a contraindication to which of the following procedures?
C5-6 anterior cervical diskectomy and fusion
Arthroscopic subacromial decompression
Which of the following patient scenarios is most appropriate for reverse total shoulder arthroplasty?
A 40-year-old laborer severe glenohumeral arthritis and irrepairable rotator cuff tear.
A 40-year-old with a painful proximal humerus malunion.
A 75-year-old woman with severe arthritis and active overhead motion.
A 75-year-old man with painful arthritis and a massive irrepairable rotator cuff tear
Failed hemiarthroplasty due to significant glenoid wear.
An 79-year-old male presents with longstanding left shoulder pain and difficulty with raising his arm over his head. His exam shows wasting of the deltoid and obvious scapular dysrhythmia on the left side. He lacks the ability to do any forward flexion or external rotation in his left shoulder. He can internally rotate without difficulty. His radiograph and MRI images are seen in figures A and B respectively. He wants to know if he is a candidate for a reverse shoulder arthroplasty (RSA). Which of the following answer choices is the MOST appropriate response?
He is a candidate for RSA due to rotator cuff tear arthropathy
He is a candidate for RSA due to ability to internally rotate
He is not a candidate for RSA due to deltoid dysfunction
He is not a candidate for RSA due to massive rotator cuff tear
He is not a candidate for RSA due to his age
Superior placement of the baseplate during reverse shoulder arthroplasty is a known technical risk factor for which of the following complications?
Inferior acromial erosion
Humeral component loosening
Inferior scapular notching
Superior scapular notching
What technical error leads to scapular notching after reverse total shoulder arthroplasty?
Superior placement of the glenoid component
Retroverted placement of the glenoid component
Inferior placement of the glenoid component
Overtensioning of the soft tissue envelope
Inferior tilt of the glenoid component
A 76-year-old man has a two-year history of shoulder pain which no longer responds to non-operative treatments. A radiograph is shown in Figure A. He has forward flexion to 80 degrees and abduction to 70 degrees. An example of his belly push examination is shown in Figure B. What is the most appropriate surgical procedure?
Arthroscopic debridement and subacromial decompression
Open rotator cuff repair
Reverse shoulder arthroplasty
Which of the following patients would be the most appropriate candidate for a reverse total shoulder replacement?
A 71-year-old man with a massive rotator cuff tear, glenohumeral arthritis, and forward elevation to 40 degrees
A 45-year-old man who has failed 3 rotator cuff repairs and has glenohumeral arthritis
A 65-year-old man with glenoid wear and pain 10 years following a hemiarthroplasty
A 72-year-old man with severe glenohumeral arthritis and an intact rotator cuff
A 30-year-old man with a locked posterior shoulder dislocation
Early reverse total shoulder designs (before the development of the Grammont-style prosthesis) had a high failure rate due to early loosening of the glenoid component. What biomechanical feature accounted for this problem?
Glenoid component did not have a neck
Humeral component too horizontal
Center of rotation too lateral
Center of rotation too anterior
Center of rotation too inferior
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HPI - 69 male complicated r shoulder hx.
Initial proximal humerus fx. Had ORIF. Did ok but developed impingement. Eventually had removal of hardware and rotator cuff repair.
Then had p acnes infection. Was treated with IV abx protocol and shoulder wash out twice.
Now presents to me with shoulder pain.
MRI shows large cysts in humeral head.
Aspiration showed continued p acnes infection.
I elected to perform two staged reverse tsa.
Placed abx spacer. Pain has improved significantly.
Infection labs have always been normal.
Now do I:
Plan for placement of reverse while obtaining frozen, but will p acnes show up?
Place reverse along with calcium sulfate abx beads?
How to determine if p acnes infection has been irradicated?