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Shoulder Procedure Volumes in Orthopaedic Residency: Long-Term Disparities and a Case for Arthroplasty Minimums.

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Related Experiment Video

Updated: Feb 15, 2026

Reverse Total Shoulder Arthroplasty
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Massive Rotator Cuff Tear: When to Consider Reverse Shoulder Arthroplasty.

Thomas R Sellers1, Adham Abdelfattah2, Mark A Frankle3

  • 1Department of Orthopaedic Surgery, University of South Florida, Tampa, FL, USA.

Current Reviews in Musculoskeletal Medicine
|January 23, 2018
PubMed
Summary

Reverse shoulder arthroplasty (RSA) offers good outcomes for elderly patients with irreparable massive rotator cuff tears (MCT) and pseudoparalysis. Careful patient selection is crucial for successful pain relief and improved function.

Keywords:
Acromiohumeral intervalFatty atrophyMassive rotator cuff tearReverse shoulder arthroplastyRotator cuff repair

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Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Musculoskeletal Research

Background:

  • Massive rotator cuff tears (MCT) present complex treatment challenges, particularly without associated arthritis.
  • Reverse shoulder arthroplasty (RSA) is established for cuff tear arthropathy (CTA).

Purpose of the Study:

  • To review indications for RSA in massive rotator cuff tears (MCT).
  • To evaluate reported outcomes of RSA for MCT.
  • To outline a surgical approach for these patients.

Main Methods:

  • Literature review of studies on RSA for MCT and CTA.
  • Analysis of patient selection criteria and outcomes.
  • Description of surgical technique.

Main Results:

  • RSA is successful for CTA; its use in non-arthritic MCT is debated.
  • Elderly, lower-demand patients with chronic, irreparable MCT and pseudoparalysis are best candidates for RSA.
  • Long-term follow-up shows >90% implant survival at 10 years for RSA in CTA and MCT.
  • Risk factors for poor outcomes include age <60, high pre-operative function, and neurologic dysfunction.

Conclusions:

  • Individualized treatment is essential for MCT.
  • Optimized patient selection makes RSA a reliable option for pain relief and functional improvement.
  • Further research is needed to refine indications and explore alternative joint-sparing procedures.