Shoulder Unit- Reverse TSA

Question 1

rTSA

Answer 1

Designed specifically for the treatment of GH arthritis when it is associated with irreparable rotator cuff damage, complex fractures as well as for a revision of a previously failed conventional TSA in which the rotator cuff tendons are deficient

Question 2

What do they replace the joint with?

Answer 2

rTSA prosthesis reverses the orientation of the shoulder joint by replacing the glenoid fossa with a glenoid base plate and glenosphere and the humeral head with a shaft and concave cup

Question 3

What changes mechanically within the rTSA and why?

Answer 3

-Moves the center of rotation of the shoulder joint medially and inferiorly increasing the mechanical advantage of the deltoid muscle
>compensation for the deficient RTC

Question 4

What changes with socket and ball?

Answer 4

• “Ball” attached to glenoid fossa
• “Socket” attached to humerus

> Allows use of deltoid muscle to lift arm versus torn RTC

Question 5

Why is rehab different for rTSA vs TSA?

Answer 5

The rotator cuff is either absent or minimally involved with the rTSA therefore the rehabilitation of a patient following the rTSA is different than TSA

Question 6

Which has higher risk of dislocation? What position is the dislocation?

Answer 6

rTSA

Position of dislocation is IR and Add with extension – tucking in a shirt, personal hygiene

Question 7

How long should extension past neutral and a combo of adduction and IR be avoided?

Answer 7

should be avoided for 12 weeks postop

Question 8

What muscles is the stability of the shoulder dependent upon?

Answer 8

the deltoid and periscapular musculature