When an irreparable cuff tear results in superior elevation of the humeral head without instability, range of motion may be retained, but pain may be your chief complaint. In this situation, a humeral head replacement with an "Extended articular surface" is an option. This can provide pain relief without the potential loss of rotation or risk of complications that may accompany Reverse arthroplasty.
Further, if you are still young and "high demand"-- there may be legitimate merit in avoiding a Reverse shoulder because as you get older, there may be the risk that your activity level results in either loosening or instability. In other words, we just don't know at this point in time how long a Reverse will last.
If you are told that a Reverse type design is your only option, it may be worth it, however, the literature suggests that as long as you do not have anterosuperior escape, and can raise your arm above 90 degrees, you may be a candidate for more traditional hemiarthroplasty, albeit with a "head" that articulates with both the glenoid and the undersurface of the acromion. This procedure can help to diminish the pain that you are experiencing---in many cases tremendously . If you cannot raise your arm above horizontal, then a Reverse shoulder replacement is a better option.
While the videos attached below show a stemmed device, a newer "cap" design is now available, which has the advantage of a much easier revision to a Reverse shoulder should that ever become necessary due to loss of function or the development of painful glenoid wear over time.
Further, if you are still young and "high demand"-- there may be legitimate merit in avoiding a Reverse shoulder because as you get older, there may be the risk that your activity level results in either loosening or instability. In other words, we just don't know at this point in time how long a Reverse will last.
If you are told that a Reverse type design is your only option, it may be worth it, however, the literature suggests that as long as you do not have anterosuperior escape, and can raise your arm above 90 degrees, you may be a candidate for more traditional hemiarthroplasty, albeit with a "head" that articulates with both the glenoid and the undersurface of the acromion. This procedure can help to diminish the pain that you are experiencing---in many cases tremendously . If you cannot raise your arm above horizontal, then a Reverse shoulder replacement is a better option.
While the videos attached below show a stemmed device, a newer "cap" design is now available, which has the advantage of a much easier revision to a Reverse shoulder should that ever become necessary due to loss of function or the development of painful glenoid wear over time.
