It is being observed that some surgeons prefer to do reverse shoulder replacement rather than attempting a rotator cuff repair in the elderly patients giving justification that the results of rotator cuff repair are not 100%.
Is it scientifically correct to offer reverse shoulder arthroplasty for roator cuff tear?
It is an option for the treatment of irreparable rotator cuff tears, with or without articular degeneration. I would not recommend it for smaller tears before attempting repair, not even in the elderly.
It is an option for elderly patients with irreparable cuff tears or cuff tears with severe fatty infiltration grade 3/4 (not atrophy: fatty infiltration) and for pseudoparalysis without improvements after 3-6 months of non-op treatment.
It always needs a risk / benefit analysis to make the decision.
Mulieri and Frankle have published on RSA for irreparable cuff tears without arthritis:
JBJS 2010 PMID: 21048173
It dipendes on the quality of soft tissue,bone and the possibility to make a transfer.
The age over 80 in active patient is a good indication for rsa..
Ciao
One must consider rotator cuff repair and discuss with the patient the risk of failure of surgery and should keep RTSA as a second line back up surgery
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