total shoulder arthroplasty

Complications

Subscapularis failure

Rotator cuff failure

Instability

Infection

Periprosthetic fracture

Aseptic loosening

Neurological injury

Parada et al. J Should Elbow Surg 2021

- 2224 aTSA complication rate 11%, revision rate 5.6%

Goal

- head that translates 50% in all directions

- allows 30^o ER with arm at side

- stable posteriorly

Pre-Op 

- antibiotics

- consider specific Propionobacterium cover

Background

Meniscectomy 

- resect 30%

- increases contact pressures 3.5 x

- shock absorbing capacity reduced to 20% normal

Results of partial & total meniscectomy are very poor in children

- meniscectomy in children is a last resort

- repair amenable tears

- treat others non-operatively

- only real indication for meniscectomy is locked knee not amenable to repair

Issues

Rotator cuff

- often deficient

Bone stock

- often deficient

Glenoid

- often posterior version 

Management

Options

1.  TSR

Indications

- cuff intact