The Orthobullets Podcast Foundations | Shoulder & Elbow | Total Shoulder Arthroplasty
Dec 13, 2025
Explore the fascinating world of total shoulder arthroplasty! Discover how shoulder motion impacts surgery success and the critical factors like intact rotator cuffs. Learn about the impressive outcomes, including 93% survival rates over ten years. Delve into preoperative imaging essentials and safe rehab practices. Uncover the balance of postoperative pain management and the implications of age. Plus, hear about complications like dislocations and rotator cuff tears that can arise after surgery. This is a must-listen for anyone in the musculoskeletal field!
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Shoulder Arthroplasty Is Mechanically Distinct
- Total shoulder arthroplasty (TSA) differs from hip/knee arthroplasty due to greater shoulder motion and dependence on soft-tissue function.
- The unconstrained glenoid increases shear stresses and risk of mechanical loosening in TSA.
Select Patients By Cuff And Glenoid Quality
- Ensure an intact, functional rotator cuff and adequate glenoid bone stock before selecting patients for TSA.
- Expect predictable pain relief and reliable motion when these factors are present, with ~93% 10-year survival.
When To Choose Or Avoid Anatomic TSA
- Indicate TSA for severe pain (especially nocturnal) and ADL limitations with glenoid cartilage loss and posterior humeral subluxation.
- Avoid TSA when glenoid bone stock is insufficient or with rotator cuff arthropathy; consider hemiarthroplasty or reverse TSA instead.