She was unable to perform the tasks required on her ranch due to pain in the right shoulder. She maintained active elevation of 120 degrees. The AP radiograph revealed cuff tears.
Wishing to avoid the risks and activity limitations associated with a reverse total shoulder, she elected a hemiarthroplasty with an extended humeral articular surface that articulates with the undersurface of the acromion – the CTA hemiarthroplasty (see this link for the technique).
At surgery, there was no cartilage on the proximal part of the humerus. Also, the subscapularis and supraspinatus muscles, as well as the upper infraspinatus muscle, were irreparably detached.
Below is her postoperative x ray.
Her active motion is full and comfortable two years following her CTA Hemiarthroplasty. (Including reaching up the back)
Her ranch life was captured in these pictures, taken 15 years after she had her arthroplasty.
Notably, despite the high level of activity she engages in daily, she hasn’t experienced instability or an acromial/spine injury.
The chart below shows the minimum 2-year follow-up data for 45 CTA patients…