APEX Shoulder Mastering Surgical Techniques for Clinical Success-Anatomic TSR

Video Transcription

Video Summary

The panel discussion focused on indications, planning, and techniques for anatomic versus reverse shoulder arthroplasty, particularly for osteoarthritis and complex cases like B2 glenoids and subscapularis management. Surgeons shared that anatomic arthroplasty remains valuable, especially in patients with intact cuffs and good motion, with many doing a mix of anatomic and reverse procedures. Preoperative CT scans with planning software were strongly recommended over MRIs for assessing glenoid version and cuff status. For B2 glenoids, small augmented components are preferred over aggressive corrective reaming, with a threshold of about 15-20 degrees retroversion for correction before considering reverse arthroplasty. Subscapularis management varied among surgeons (LTO, peel, tenotomy) with no clear superior technique. Glenoid exposure emphasizes adequate humeral osteotomy and anterior soft tissue releases while preserving the anterior capsule. Importance of patient consent including the possibility of intraoperative decision changes and awareness of functional outcomes like internal rotation was highlighted.

Asset Caption

Moderator: Robert Hartzler, MD
Panel: Brian Grogan, M.D., Xinning Li, MD, Brian Waterman, M.D.

Keywords

anatomic shoulder arthroplasty

reverse shoulder arthroplasty

B2 glenoid management

subscapularis techniques

preoperative CT planning

glenoid retroversion correction