In the case below it is demonstrated that surgical exposure for a reverse shoulder replacement after failed rotator cuff repair in the elderly can be difficult. The patient is in her 70s and has stiffness to the shoulder, a high riding humeral head with shoulder arthritis and a surgical field altered due to scar tissue formation from a previous deltopectoral approach that was used for repair of the rotator cuff. The rotator cuff repair was performed 7 years ago by another surgeon. During surgery it was found that the prior surgeon detached the anterior fibers of the deltoid from the acromion (deltoid take down) and re-attached those after the repair. The partially scarred deltoid made the exposure of the glenoid a difficult task. In this case the release of the inferior capsule and removal of bone from the anterior aspect of the proximal humerus allowed for insertion of a baseplate and glenosphere. The patient had significant relief of pain a few days after her surgery.
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| High riding humeral head. Anchors from prior rotator cuff repair. Arthritis of glenohumeral joint |
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| Axillary view |
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| Exposure of the humeral head |
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| Exposure of the glenoid |
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| implantation of the baseplate |
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| implanation of the glenosphere |
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| Postoperative shoulder xray after implantation of the reverse total shoulder prosthesis |
