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Rotator Cuff Sparing Total Shoulder Arthroplasty

January 01, 2012

Contributors: Joseph D Zuckerman, MD; Ikemefuna Onyekwelu, MD; Saqib Hasan, MD; Abiola Atanda, MD; Young Ho Kwon, Prof; Young Ho Kwon, Prof

Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.
Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.

Surgeons have used total shoulder arthroplasty (TSA) to treat patients with osteo and inflammatory arthritis of the shoulder. A number of studies have demonstrated that this procedure is associated with good to excellent outcome in a majority of patients. As a result, TSA has become the treatment of choice for elderly patients with shoulder arthritis. Despite this clinical success, there are concerns that subscapularis tendon integrity may be compromised in some patients, which can lead to inferior outcomes. Therefore, LaFosse et al. introduced a novel surgical technique for TSA where the prosthesis can be inserted through the rotator interval. In this fashion, all of the rotator cuff tendons, including the subscapularis, can remain intact during the procedure. Theoretical advantages of this approach include improved subscapularis function, decreased failure rate, and accelerated postoperative rehabilitation. In this multimedia program, we illustrate a modification of this published technique and discuss its advantages and limitations to provide a comprehensive update of this promising surgical concept.

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