Reverse total shoulder arthroplasty (RTSA) is considered by many as the “go to” procedure for patients with rotator cuff tear arthropathy. The complications of RTSA are not uncommon and can be very difficult to treat: acromial/spine injuries, dislocations and baseplate failures.
Here we present two patients referred to us for this procedure who wished to avoid RTSA out of concerns for its complications.
First, a woman in her 75s with a painful shoulder on the right was referred to RTSA for treatment after 10 steroid shots failed to improve comfort and function. She had 60 degrees of active elevation and 80 degrees of passive elevation. Her x-rays, shown below, show classical findings of cuff arthropathy.
A retired 80-year-old banker who had a previous cuff repair on the right shoulder failed was referred to RTSA. He had 160 degrees of active elevation, but could not enjoy golf because of right shoulder pain and crepitance. The x-rays of his shoulder show typical findings for cuff tears arthropathy.
Not wanting an RTSA, how should he be managed?
The first patient placed on the gentle patient-conducted…