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.

Meta Tag

Concept Pseudoparalysis

Concept Rotator Cuff Pathology

Concept Reverse Shoulder Arthroplasty

Concept Stiff Shoulder

Concept Acromial Fracture

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

Pseudoparalysis

Rotator Cuff Pathology

Reverse Shoulder Arthroplasty

Stiff Shoulder

Acromial Fracture