Revision of failed anatomic total shoulder arthroplasty to reverse for subscapularis failure

In chronic ruptures of the subscapularis after anatomic total shoulder arthroplasty the dilemma arises. Should someone repair the subscapularis with a graft or convert to a reverse total shoulder replacement? If the patient is older than 65-70 years and is a low demand patient then the best option is a conversion to a reverse. The following example illustrates such approach. The patient regained full ROM after the revision. Prior to the revision her active forward elevation was to 50 degrees.