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

Video Transcription

Video Summary

A panel discusses three reverse shoulder arthroplasty cases and decision-making around diagnosis, implant design, and complications. Case 1 is a 68-year-old woman with severe pain and stiffness after a fall. The surgeons debate whether her limited exam reflects frozen shoulder, pain hypersensitivity, or true pseudoparalysis/pseudoparesis, using injections, steroid packs, PT, and MRI to clarify. Imaging suggests a chronic cuff tear with reasonable tendon length; after reassessment they proceed with reverse arthroplasty. They compare implant strategies (135° vs 155°, humeral lateralization, baseplate offset, glenosphere sizing/coverage) and emphasize inferior tilt/positioning. She later sustains an acute acromial fracture during rehab; management ranges from sling/observation to acute fixation, stressing osteoporosis optimization and avoiding overtensioning. Case 2 is a complex, neglected proximal humerus fracture-dislocation requiring reverse with careful tuberosity management, possible plating/cerclage, neutral glenoid options for fractures, larger glenospheres for stability, and low threshold for cement. Case 3 features multiple failed cuff repairs and high risk for fracture/infection; they choose a conservative, inlay-based reverse plan with cautious rehab and discuss pearls for achieving proper tension and stability.

Asset Caption

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

Keywords

reverse shoulder arthroplasty

pseudoparalysis vs frozen shoulder diagnosis

implant design (135° vs 155°) and lateralization

glenosphere sizing and inferior baseplate positioning

acromial fracture complication management

proximal humerus fracture-dislocation reverse arthroplasty