Cuff Tear Arthropathy: A Conundrum of Choice

Many surgical treatment options exist for cuff tear arthropathy, but in our opinion, the most reliable options include the unconstrained hemiarthroplasty and the reverse total shoulder arthroplasty. Currently our indications for a hemiarthroplasty consist of a patient with a contained head, no superior migration (Seebauer 1A and 1B), no previous violation of the coracoacromial arch, reasonable preoperative range of motion, and younger age. On the other hand, we believe indications for a reverse total shoulder arthroplasty include the older patient with a pseudoparalytic shoulder, superior migration (Seebauer type 2A or 2B), and loss of the coracoacromial arch.