Shoulder Arthroplasty & Arthritis MCQs

A 78-year-old woman sustains a 4-part proximal humerus fracture with head splitting and osteopenia. She lives independently and is a community ambulator. What is the most reliable surgical option to predictably restore forward elevation?

A 72-year-old woman undergoes a reverse total shoulder arthroplasty for cuff tear arthropathy. To minimize the risk of scapular notching, which of the following is the optimal positioning strategy for the glenoid baseplate?

After an anatomic total shoulder arthroplasty performed via a deltopectoral approach, a patient presents at 6 weeks with sudden onset of weakness in internal rotation and increased passive external rotation. What is the most likely complication?

How does a reverse total shoulder arthroplasty (RTSA) fundamentally improve shoulder function in a patient with advanced rotator cuff tear arthropathy?

A 72-year-old woman undergoes a reverse total shoulder arthroplasty. At her 1-year follow-up, she complains of mild pain. Radiographs reveal inferior scapular notching (Sirveaux grade 2). Which of the following surgical modifications during the index procedure would have most likely decreased the risk of this complication?

A 72-year-old woman is 3 years status post reverse total shoulder arthroplasty (RTSA) using a Grammont-style prosthesis. Radiographs show a grade 3 inferior scapular notch. Which of the following technical errors during the index procedure most significantly increases the risk of this complication?

A 72-year-old female presents with worsening shoulder pain 5 years after undergoing a Reverse Total Shoulder Arthroplasty (RTSA). Radiographs show a radiolucent line under the inferior glenosphere baseplate with associated bone loss (Sirveaux Grade 3 scapular notching). Which surgical factor is most associated with this complication?

A 78-year-old female with known severe osteoporosis falls from a standing height. Radiographs reveal a highly displaced 4-part proximal humerus fracture with a head-split component. She is independent and medically fit for surgery. Which of the following treatments provides the most predictable functional outcome?

A 75-year-old female sustains a comminuted 4-part proximal humerus fracture. Due to her age, poor bone quality, and comminution, she is treated with a reverse total shoulder arthroplasty (RTSA) rather than open reduction and internal fixation. Compared to hemiarthroplasty for this indication, RTSA is associated with:

A 68-year-old female with chronic pseudoparalysis of the right shoulder and a massive irrepairable rotator cuff tear undergoes a reverse total shoulder arthroplasty (RTSA). The biomechanical advantage of RTSA that restores active elevation is primarily achieved by:

In reverse total shoulder arthroplasty (RTSA), changing the center of rotation alters the biomechanical advantage of the deltoid muscle. Which of the following best describes the kinematic changes associated with a Grammont-style RTSA design compared to the native shoulder?

To minimize the risk of scapular notching following a reverse total shoulder arthroplasty (RTSA), how should the glenosphere component optimally be positioned on the baseplate?

A 70-year-old woman is scheduled to undergo a reverse total shoulder arthroplasty for cuff tear arthropathy. The Grammont-style reverse prosthesis changes the biomechanics of the shoulder joint to restore active elevation. Which of the following best describes this biomechanical alteration?

A 72-year-old female undergoes reverse total shoulder arthroplasty (RTSA) for severe rotator cuff tear arthropathy. By what primary biomechanical mechanism does this prosthesis restore active shoulder elevation?

A 72-year-old woman undergoes a reverse total shoulder arthroplasty (rTSA) for cuff tear arthropathy. Postoperatively, she achieves 150 degrees of active forward elevation but complains of profound weakness and inability to actively externally rotate her arm when at her side. Which of the following concurrent procedures would have best addressed this specific postoperative deficit?

A 75-year-old man is 4 years status post a Grammont-style reverse total shoulder arthroplasty. Radiographs show Grade 3 scapular notching. Which intraoperative technical error most significantly increases the risk of this specific complication?

An orthopaedic surgeon is planning an anatomic total shoulder arthroplasty for a 68-year-old man with primary osteoarthritis. Preoperative axillary CT imaging demonstrates a biconcave glenoid with severe posterior cartilaginous wear and 22 degrees of retroversion. According to the Walch classification, what type of glenoid morphology is this?

A 72-year-old woman undergoes a reverse total shoulder arthroplasty for severe rotator cuff tear arthropathy. To minimize the risk of scapular notching postoperatively, which of the following baseplate and glenosphere configurations is most appropriate?

A 72-year-old woman undergoes reverse total shoulder arthroplasty (rTSA) for massive, irreparable rotator cuff tear arthropathy. Postoperatively, what surgical technique modification regarding glenoid baseplate and glenosphere positioning has been biomechanically and clinically proven to minimize the risk of inferior scapular notching?

A 65-year-old woman with cuff tear arthropathy undergoes a reverse total shoulder arthroplasty. During templating and component positioning, which of the following modifications minimizes the risk of scapular notching?