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C5-6 anterior cervical diskectomy and fusion
1%
19/2922
Reverse total shoulder arthroplasty
97%
2838/2922
Shoulder arthrodesis
20/2922
Biceps tenodesis
0%
14/2922
Arthroscopic subacromial decompression
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Deltoid denervation is an absolute contraindication for reverse total shoulder arthroplasty (TSA). Distal displacement of the center of joint rotation increases the lever arm of the deltoid and also recruits portions of the anterior and posterior heads of the deltoid to act as abductors of the arm, permitting elevation above shoulder height. Failure of the deltoid to function correctly will limit patient outcomes and can even lead to implant instability. The referenced study by Gerber and Boileau cover the reverse TSA implant, including design, indications, and outcomes. They note that reverse total shoulder arthroplasty has become popular for use for more than rotator cuff-tear arthropathy; its uses include treatment of failed conventional total shoulder arthroplasties, rheumatoid arthritis in patients with an irreparable cuff tear, proximal humeral tumors, and proximal humeral fractures with anterosuperior escape. The referenced study by Matsen et al is a review of the reverse TSA. It reviews complications of this prosthesis, such as: aseptic loosening, instability, glenosphere dissociation, humeral disassembly, infection, humeral fracture, neurapraxia, and scapular notching. Illustration A shows a radiograph of such a prosthesis.
3.6
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