APEX Shoulder Mastering Surgical Techniques for Clinical Success-Reverse Shoulder Arthroplasty

Video Transcription

Video Summary

The panel discusses complex shoulder arthroplasty cases, focusing on diagnosis, treatment, and implant selection. Case 1 involves a 68-year-old woman with post-traumatic shoulder stiffness and pain, suspected frozen shoulder rather than pseudoparalysis; the team emphasizes non-surgical management first, including injections, steroids, and physical therapy. For chronic irreparable rotator cuff tears with pseudoparalysis, reverse shoulder arthroplasty (RSA) is preferred. The panel debates implant design preferences, mainly favoring a 135° stem with lateralization and onlay humeral components to optimize stability and range of motion. Acromial fractures post-RSA are recognized complications, often requiring surgical fixation. Case 2 presents a challenging fracture-dislocation managed with reverse arthroplasty plus tuberosity fixation, emphasizing stability and tuberosity preservation. The final case involves a complex patient with multiple prior surgeries and osteopenic bone, requiring careful planning, conservative rehab, and a focus on implant tensioning and stability. Key takeaways highlight the importance of individualized surgical planning, implant selection, and intraoperative tension assessment to improve outcomes.

Asset Caption

Moderator: Brian Waterman, M.D.
Panel: Xinning Li, M.D., Michael O’Brien, M.D., Andrew Razzano, D.O.

Keywords

shoulder arthroplasty

reverse shoulder arthroplasty

rotator cuff tear

implant design

acromial fracture

tuberosity fixation