Glenohumeral (shoulder) arthritis occurs when the protective cartilage on the surface of the glenoid (socket of the shoulder joint) and the humeral head (ball of the shoulder joint of the upper arm) wears out. This cartilage surface breaks down from genetic susceptibility, excessive joint loading over time, or following injury. As a result, shoulder pain and limitations occur as the worn ends of the bones in the joint grind together, deform, and cause inflammation and symptoms.

The most common indication for a reverse total shoulder arthroplasty is painful rotator cuff arthropathy (shoulder arthritis with a large rotator cuff tear). Significant or massive rotator cuff tears that are left untreated can result in the humeral head migrating upward and moving closer to the acromion (roof of the shoulder joint). This abnormal position causes the cartilage covering the bony surfaces to deteriorate (arthritis), often resulting in significant pain and physical limitations. Reverse total shoulder arthroplasty is also indicated for patients with pain associated with large irreparable rotator cuff tears or severe fractures of the proximal humerus in older patients.

Dr. Chudik makes a limited incision over the front of the shoulder and works through intervals in the shoulder and chest muscles so he can resurface the humerus (ball) and the glenoid (socket). These worn surfaces are replaced with metal and special plastic components that are fit to your shoulder. In a reverse total shoulder replacement, the ball and socket are anatomically reversed. The ball is placed over the glenoid and the socket is placed on the humerus (arm bone).  This technique has been found to produce better outcomes than the traditional TSA in patients who do not have a properly functioning rotator cuff.

Reverse total shoulder arthroplasty has emerged as a solution for patients with end-stage rotator cuff arthropathy. However, reverse total shoulder arthroplasty is a new, nonanatomic approach to the treatment of a variety of difficult shoulder conditions that have had frequent and substantial complications. Although current prostheses have been developed to address the concerns, persistent problems and high complication rates continue. Therefore, our research examines the coracoacromial arch and its anatomy as it relates to the stabilizing function of the rotator cuff to perhaps develop better alternatives to reverse total shoulder arthroplasty for patients with rotator cuff deficient shoulders.